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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380540292
Report Date: 07/19/2022
Date Signed: 07/19/2022 02:07:49 PM


Document Has Been Signed on 07/19/2022 02:07 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:SAN FRANCISCO TOWERSFACILITY NUMBER:
380540292
ADMINISTRATOR:CHRISTINA SPENCEFACILITY TYPE:
741
ADDRESS:1661 PINE STREETTELEPHONE:
(415) 776-0500
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY:350CENSUS: 306DATE:
07/19/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Administrator, Christina SpenceTIME COMPLETED:
02:15 PM
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On 7/19/2022, Licensing Program Analyst (LPA), Murial Han conducted an unannounced walk-through/ inspection of facility's Memory Care Unit located on the Mezzanine Level only with no change in the total facility's capacity of 350. Fire Clearance was granted by San Francisco Fire Department on 7/14/2022.

The total capacity for the memory care unit is 15 and most of the rooms are private with 2 semi-private rooms. All the rooms have call light system installed.

During today's visit, LPA was provided a tour by the administrator, the health services administrator and the maintenance staff. The tour was conducted based on the facility's floor plan.

During the tour, LPA observed the egress doors/entrances and exits are operated by the key FOB device. LPA and facility staff tested the egress doors by the front entrance with 15 second delay panic hardware and the egress exit door to the stairwell by room 110 and both doors functioned properly. LPA observed water temperature in random resident's rooms (112, 109, 108, and 107), staff bathroom, shower rooms, dinning room sinks, and all the temperatures observed to be within the range of 105.4- 109.2 degrees Fahrenheit. LPA observed grab bars installed in bathrooms and showers rooms.

LPA observed emergency exits and the corridors latched properly.

No deficiencies cited. This report was discussed with the Administrator, and a copy is provided.
SUPERVISOR'S NAME: Julio MontesTELEPHONE: (650) 266-8811
LICENSING EVALUATOR NAME: Murial HanTELEPHONE: (619) 209-9761
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2022
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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