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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 275201799
Report Date: 11/08/2024
Date Signed: 11/08/2024 04:11:56 PM

Document Has Been Signed on 11/08/2024 04:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SOCIAL VOCATIONAL SERVICES,SALINAS #2FACILITY NUMBER:
275201799
ADMINISTRATOR/
DIRECTOR:		ELISABETH MARTINFACILITY TYPE:
775
ADDRESS:335 ABBOTT STREETTELEPHONE:
(831) 245-0311
CITY:SALINASSTATE: CAZIP CODE:
93901
CAPACITY: 90CENSUS: 48DATE:
11/08/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Program Director, Elisabeth MartinTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Program Director, Elisabeth Martin. There are currently 48 clients receiving services at this facility location. LPA inspected the interior and the exterior of the facility including the entryway, bathrooms, activity rooms, storage areas, and office.

Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 94 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are in a room that is supposed to be locked, inside cabinet with a lock, however the door and lock on cabinet were both open. The facility does have an LIC610D however it is on an outdated form, and not updated annually a required.

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Program Director, Elisabeth Martin, and copy of report left at facility
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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