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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 405850147
Report Date: 02/04/2023
Date Signed: 02/04/2023 12:43:28 PM


Document Has Been Signed on 02/04/2023 12:43 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364



FACILITY NAME:ALL SEASON CAREFACILITY NUMBER:
405850147
ADMINISTRATOR:ESTOQUE, ANALYN MFACILITY TYPE:
740
ADDRESS:1637 LEAH WAYTELEPHONE:
(805) 234-2500
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:6CENSUS: 4DATE:
02/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Licensee, Amaylyn Deliema, TIME COMPLETED:
12:38 PM
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At 8:25am, on 02/04/2023, Licensing Program Analyst (LPA) Jeffries arrived at the facility unannounced to
conduct the annual, infection control inspection. LPA was properly screened upon entrance in accordance with
current infection control best practices. LPA met with licensee, Amaylyn Deliema, and announced who he was
and the reason for the visit.
Licensee and LPA conducted a cursory tour of the entire facility. This facility is a five bedroom, three
bathroom, living room kitchen and dining room layout with laundry room and garage, there is an backyard patio
with umbrella for shade. Medications are locked in a cabinet in the dinning room area and staff and client files
are locked in a enclave of the dining room. The facility has battery operated fire alarms in each room that are
all working and in the green, the carbon monoxide detector is in the hallway and functioning normally. All the
door ways and exits are free and clear of debris and hazards. LPA observed a working fire extinguisher near
the kitchen dining room area. LPA tested facility water and was within regulation temperatures 105*-120* (f).
LPA observed at least 2 days of perishable and at least 7 days of non perishable foods. LPA observed a 30
day supply of PPE and incontinence supplies on hand at the facility. LPA observed liquid soap and paper towel
dispensers in all bathroom of the facility. LPA noted that the facility was clean and in good repair. LPA noted
that the cursory tour did not indicate any violations, technical or citations during the cursory tour walk through.
Licensee and LPA conducted the infection control module of the annual inspection. LPA noted that there
were no citation, technical or citations issued during the infection control module of the annual inspection. LPA
noted that there were no violations, technical or citations issued during this annual inspection.
Exit interview, report signed, and report given.
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Mark JeffriesTELEPHONE: (805)562-0400
LICENSING EVALUATOR SIGNATURE:
DATE: 02/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2023
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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