392700719-2-7-2022-27-AS-AMAZ-CBEMZ2-20220207090222

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 392700719
Report Date: 01/03/2022
Date Signed: 02/07/2022 09:02:24 AM

Document Has Been Signed on 02/07/2022 09:02 AM - 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME:	OPENDOOR SERVICES		FACILITY NUMBER:	392700719
ADMINISTRATOR:	NAKAWATASE, JOHN		FACILITY TYPE:	775
ADDRESS:	1129 ENTERPRISE ST		TELEPHONE:	(209) 475-1529
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95204
CAPACITY: 165		CENSUS: 35	DATE:	01/03/2022
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	John Nakawatase and Sherrie Wilker-Loza		TIME COMPLETED:	11:00 AM

NARRATIVE

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Licensing Program Analyst (LPAs) Avelina Martinez and Maja Jensen made an unannounced visit to this facility to conduct an annual inspection on 01/03/2022 at 10:08 AM. LPA met with John Nakawatase and stated the purpose of today’s visit. LPAs inspected the physical plant including but not limited to interior and outside courtyards of the facility to ensure compliance with Title 22 regulations.

Administrator holds current certificate . The Day Program facility is licensed for 165 ambulatory, which 10 may be non-ambulatory. There are currently 35 clients who attend this facility.

LPA Martinez and LPA Jensen toured the facility with the John Nakawatase on 01/03/2022 at 10:30 AM.

The facility has submitted an LIC 808 mitigation plan, and it was approved. The facility has covid-19 postings throughout the facility. The facility has a supply of PPE and has hand sanitizer. The facility has one central screening entry point. The facility common areas and bathroom are sanitary. Facility furniture is spaced 6 feet apart. The facility fire extinguishers and smoke detectors are in good repair. The exterior of the facility is sanitary and clear of debris. In addition, the facility has a shaded sitting area outside for residents.

There were no deficiencies observed or cited at this annual inspection visit. An exit interview was conducted, and a copy of this 809 report was given to John Nakawatase.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022

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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