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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 385600398
Report Date: 03/20/2024
Date Signed: 03/20/2024 03:41:19 PM


Document Has Been Signed on 03/20/2024 03:41 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:SUNSET CARE HOME 2FACILITY NUMBER:
385600398
ADMINISTRATOR:ZHANG, ALICE FENGFACILITY TYPE:
740
ADDRESS:1367 39TH AVENUETELEPHONE:
(415) 516-9368
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:6CENSUS: 0DATE:
03/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Alice Zhang, Administrator/LicenseeTIME COMPLETED:
03:45 PM
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On March 20, 2024 at 3:50 PM, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required visit. LPA Calandra met with Alice Zhang, Licensee/Administrator and explained the purpose of his visit.

This facility is licensed to serve 6 residents who are 60 or older, of which 6 out 6 residents may be non-ambulatory

The facility currently does not have any residents in care. Alice Zhang expressed to the LPA that she is unsure if she will obtain residents at this time.

LPA Calandra toured the physical plant. This is a 2 story building which consists of a living room, dining room, kitchen, Garage, 4 bedrooms and 3 bathrooms. No accessible bodies of water or hazards were observed. Each bedroom was observed to have sufficient lighting and the required furniture. No food was inspected as there were no residents in care at the time of the inspection. Fire extinguishers were observed to be fully charged and last inspected on December 4, 2023. The facility's laundry machines were observed to be in good repair.

No records or medications were reviewed during today's visit as there are no residents currently.

The Annual Inspection will be continued at a later date.

No deficiencies were cited during today's visit.

This report was reviewed with Administrator/Licensee, Alice Zhang 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: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2024
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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