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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
385601084
Report Date:
05/12/2023
Date Signed:
05/12/2023 12:23:18 PM
Document Has Been Signed on
05/12/2023 12:23 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
SF COASTAL AC/SC
,
851 TRAEGER AVE., SUITE 360
SAN BRUNO
,
CA
94066
FACILITY NAME:
LYNNE & ROY M FRANK RESIDENCES
FACILITY NUMBER:
385601084
ADMINISTRATOR:
TANG, EDWINA
FACILITY TYPE:
740
ADDRESS:
ONE AVALON AVENUE
TELEPHONE:
(415) 562-2855
CITY:
SAN FRANCISCO
STATE:
CA
ZIP CODE:
94112
CAPACITY:
220
CENSUS:
150
DATE:
05/12/2023
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
10:50 AM
MET WITH:
Edwina Tang
TIME COMPLETED:
12:30 PM
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On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management - other visit to discuss admission policies of the facility.
LPA met with executive director Edwina Tang and assistant executive director Robert Sarison. LPA explained the purpose of today's visit.
The facility does have admission policies and practices regarding determining responsible party for admission. LPA was provided a copy of the current admission practices for memory care. Per the facility placement in the facility is determinant on who is the responsible person for the resident being admitted in. It was discussed that the facility does work with the family member(s) on who is responsible for the placement. If the resident does have a durable power of attorney (DPOA) they rely on the documentation received. The facility is continually adjusting the admission practices and is in the process of updating the admissions policy for clarity and to ensure that the facility is taking the right steps in regards to resident admission practices.
Report is reviewed with the executive director Edwina Tang.
No citations are issued.
SUPERVISORS NAME
:
Cara Smith
LICENSING EVALUATOR NAME
:
Jaime Vado
LICENSING EVALUATOR SIGNATURE
:
DATE:
05/12/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/12/2023
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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