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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 385600423
Report Date: 01/31/2024
Date Signed: 01/31/2024 02:36:40 PM


Document Has Been Signed on 01/31/2024 02:36 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:SAGEBROOK SENIOR LIVING AT SAN FRANCISCOFACILITY NUMBER:
385600423
ADMINISTRATOR:FAIMAFILI HOWARDFACILITY TYPE:
740
ADDRESS:2750 GEARY BLVDTELEPHONE:
(415) 346-0246
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:111CENSUS: DATE:
01/31/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:16 AM
MET WITH:Fili Igafo, Executive DirectorTIME COMPLETED:
02:40 PM
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On January 31, 2024, Licensing Program Analyst(LPA) John Calandra, arrived at the facility at 8:16 AM to conduct a Plan of Correction(POC) visit. LPA Calandra met with Fili Igafo, Executive Director and explained the purpose of his visit.

No deficiencies were cited during today's visit. The report and POC clearance letter was reviewed with Fili Howard, Executive Director and a copy left at the facility.
SUPERVISOR'S NAME: Cara SmithTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: John CalandraTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024
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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