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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700978
Report Date: 05/18/2023
Date Signed: 05/18/2023 11:19:13 AM

Document Has Been Signed on 05/18/2023 11:19 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:QUARTER HOUSE, LLCFACILITY NUMBER:
392700978
ADMINISTRATOR:CAMPBELL, SCOTT R.FACILITY TYPE:
735
ADDRESS:2111 LIVINGSTON LANETELEPHONE:
(209) 351-4808
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 4CENSUS: 4DATE:
05/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Christina Huerta - Assistant AdministratorTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced Annual Required 1 Year Inspection Visit. LPA met with assistant administrator and explained the purpose of the visit.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms of which 4 bedrooms are occupied by the clients. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. The hot water temperature in the clients’ shared bathroom was measured at 109 degrees Fahrenheit. Clients’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7 day supply of nonperishable and 2 day of perishable foods.

Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on 10/20/2023. Emergency Disaster Plan was last posted on 02/18/2022. First aid kit was observed to be complete. Fire drill was last conducted on 04/20/2023.

LPA reviewed two (2) staff record files and the facility has sufficient staffing to provide the services needed to meet the residents’ needs. Staff have criminal record clearance and are associated to the facility. LPA reviewed two (2) residents’ files.

No deficiencies were observed or cited from the California Code of Regulations, Title 22 and California Health and Safety Code.

Exit interview conducted with Administrator and a copy of this report provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Ruth Wallace
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2023
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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