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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700915
Report Date: 11/22/2021
Date Signed: 11/23/2021 10:59:28 AM

COMPREHENSIVE INSPECTION
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:ROBUST CARE HOME, LLCFACILITY NUMBER:
392700915
ADMINISTRATOR:UBALDO, YASHMINFACILITY TYPE:
740
ADDRESS:1627 MERIDIAN STREETTELEPHONE:
(650) 653-1608
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY:4CENSUS: 0DATE:
11/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Yashmin UbaldoTIME COMPLETED:
03:00 PM
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Unannounced annual visit made out to this facility on 11/22/2021 by LPA Charlie Yang. Upon approach to this facility this LPA observed that there weren't any postings related to COVID 19 on the entrance. This LPA observed that all of the blinds were closed. This LPA rang the doorbell and waited for a response from within this facility. After several minutes, another attempt was made.
There weren't any indications that someone was present at this time with any residents in care.
This LPA reached out to the facility designated Administrator, Yashmin Ubaldo, at (650) 653-1608 and was able to discuss the current situation with this facility.
It was learned that there weren't any residents in care at this time due to pending approval from Valley Mountain Regional Center for vendorization. As a result, there weren't any caregivers present as well.
She stated that there have not been any alterations or changes made to this facility since the Prelicensing visit that was conducted on 11/18/2020.
This visit will serve as the annual visit and will suffice since there have not been any changes performed to this facility and its physical plant. In addition, there weren't any residents present for care and supervision including the lack of staff presence as well.
A copy of this report will be submitted to the facility designated Administrator Yashmin Ubaldo at the following email address, robustcarehome@gmail.com, for her signature and the signed copy will be returned to this LPA.

Exit Interview
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Charlie YangTELEPHONE: (916) 709-6507
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021
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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