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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410508648
Report Date: 11/27/2024
Date Signed: 11/27/2024 03:12:28 PM

Document Has Been Signed on 11/27/2024 03:12 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BRITANNIA HOUSEFACILITY NUMBER:
410508648
ADMINISTRATOR/
DIRECTOR:
WILLIAMS, DELPHINEFACILITY TYPE:
740
ADDRESS:1608 ALAMEDA DE LAS PULGASTELEPHONE:
(650) 361-8383
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 6CENSUS: 5DATE:
11/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:32 PM
MET WITH:Delphine Williams, Licensee and Mark Williams, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On November 27, 2024, Licensing Program Analyst(LPA) John Calandra, arrived at the facility at 1:32 PM, to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Delphine Williams, Licensee and explained the purpose of the visit. Mark Williams, Administrator arrived later during the visit.

LPA Calandra toured the physical plant. This is a 2-story building (residents only live on the first floor) with 4 bedrooms and 2 bathrooms, a backyard, front yard, kitchen, living room, dining room, and sun room. All bedrooms were sufficiently lit and had the required furniture. All smoke detectors and carbon monoxide detectors were observed to be functioning. No accessible bodies of water or hazards were observed. The facility had the required 7 days of non-perishables and 2 days of perishables. No food was expired. All fire extinguishers were observed to be fully charged. The facility was maintained at a comfortable temperature. Hot water was measured within the required 105-120 degrees.

All sharp objects, knives, detergent, and poisons were locked and in-accessible to persons in care.

LPA Calandra reviewed 5 resident records and 3 staff records. All were observed to be complete.

No deficiencies were cited during today's visit.

The Annual will be completed at a later date.

An exit interview was conducted. This report was reviewed with Mark Williams, Administrator and a copy of the report left at the facility.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2024
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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