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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 385601097
Report Date: 03/21/2024
Date Signed: 03/21/2024 02:38:31 PM


Document Has Been Signed on 03/21/2024 02:38 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:SUTRO HEIGHTS CORPORATIONFACILITY NUMBER:
385601097
ADMINISTRATOR:PACALDO, JULIETFACILITY TYPE:
740
ADDRESS:659 45TH STREETTELEPHONE:
(415) 571-8531
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:14CENSUS: 8DATE:
03/21/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Laymer Pamintuan, Charlene Pamintuan, Administrators and Juliet Pacaldo, Licensee/AdministratorTIME COMPLETED:
02:45 PM
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On March 21, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 8:45 AM to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Julio Yap, Caretaker and explained the purpose of his visit. Laymer Pamintuan, Administrator and Charlene Pamintuan, Administrator, and Juliet Pacaldo, Licensee/Administrator joined the visit later.

LPA Calandra toured the physical plant. This is a 2 story building which consists of 7 bedrooms and 3 bathrooms, a kitchen, living room, dining room, office, laundry room, backyard, and front entry area. The fire extinguishers were observed to be fully charged and last checked on September 7, 2023. No accessible bodies of water or hazards were observed in the backyard or hallways. The facility was maintained at a comfortable temperature of 72 degrees Fahrenheit. Fire Alarms and Carbon Monoxide detectors were observed to be fully functional. Water temperature was measured above the required 125 degrees Fahrenheit. In the presence of the LPA, Laymer turned down the temperature of the water.

LPA Calandra reviewed 5 resident files. All were observed to be complete.

LPA Calandra also reviewed 5 staff files.

A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication records(CSMR) kept at the facility.

The Annual Inspection will be completed at a later date.

No deficiencies were cited during today's visit.

This report was reviewed with Administrator, Charlene Pamintuan 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: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2024
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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