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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 397005665
Report Date: 11/12/2021
Date Signed: 11/23/2021 11:12:50 AM

Document Has Been Signed on 11/23/2021 11:12 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 INC.FACILITY NUMBER:
397005665
ADMINISTRATOR:RICK ECCLESFACILITY TYPE:
775
ADDRESS:117-119 SYCAMORE AVE.TELEPHONE:
(209) 475-1529
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY: 60CENSUS: 20DATE:
11/12/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Karsha HensonTIME COMPLETED:
12:30 PM
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Unannounced annual visit made out to this day program on 11/12/2021 by LPA Charlie Yang and was met by the Assistant Director Karsha Henson who was briefly interviewed.
This day program is set up as a Behavioral Management Program while maintaining a staff to client ratio of 3:1 at all times.
Current census was 20 clients with 7 staff on site.
Tour of this day program was conducted.
Admission area in the front office was toured where visitors were digitally scanned prior to crossing over into the main areas.
Office areas were toured as well.
This day program consisted of a main room utilized for several purposes throughout the day. During this visit, this LPA did observe that lunch was being eaten and this space was set up as such. It was learned that after lunch, this common room will be moved and shifted to suit the needs of the next activities. Furniture was observed to be sufficient and able to meet the needs of the clients at this time.
Tour of the client restrooms was conducted. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees.
It was observed that there wasn't a kitchen area designated for cooking and preparing meals. All lunches are provided by the responsible party of the attending clients to this day program. There was an area designated for microwave use in order to heat up food that was brought in by the clients for lunch.
Fire extinguisher, located in the microwave area, was observed to have been annually inspected on 07/17/2021 by the local fire equipment company and in compliance at this time.
Closet for cleaning supplies was observed to be locked and made inaccessible to the clients at this time.
Isolation room was toured.
It was learned that this area was designated for COVID related issues whenever a client exhibited symptoms and precautionary measures had to take place.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 11/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/12/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 INC.
FACILITY NUMBER: 397005665
VISIT DATE: 11/12/2021
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The exterior grounds of this facility was reviewed. Area designated for client pick up/drop off was toured. Perimeter fence, employee entrance, and main entrance were toured.

The following forms and documents were requested to be updated and submitted into CCL:

LIC 308

LIC 400

LIC 500

LIC 610

There were no deficiencies observed or cited during today's annual visit.

Exit Interview
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2021
LIC809 (FAS) - (06/04)
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