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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380540130
Report Date: 03/06/2024
Date Signed: 03/06/2024 03:49:30 PM


Document Has Been Signed on 03/06/2024 03:49 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:ST. FRANCIS MANOR IFACILITY NUMBER:
380540130
ADMINISTRATOR:ELMORALY, AMALFACILITY TYPE:
740
ADDRESS:1450 PORTOLA DRIVETELEPHONE:
(415) 564-8794
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94127
CAPACITY:12CENSUS: 4DATE:
03/06/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:31 PM
MET WITH:Amal Elmoraly, Administrator/Licensee and Walla Elmoraly, Caretaker TIME COMPLETED:
04:00 PM
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On March 6, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 3:30 PM to conduct a Case Management visit to deliver an Amended report from the Annual 1-year required inspection on February 20, 2024. LPA Calandra met with Amal Elmoraly, the Licensee/Administrator and explained the purpose of his visit. Walla Elmoraly, Caretaker later during the visit.

No deficiencies were cited during today's visit.

This report was reviewed with Amal Elmoraly, Licensee/Administrator and Walla Elmoraly, Caretaker and a copy of the report left at the facility.
SUPERVISOR'S NAME: Cara SmithTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: John CalandraTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2024
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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