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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600267
Report Date: 08/13/2021
Date Signed: 08/13/2021 11:51:14 AM

Document Has Been Signed on 08/13/2021 11:51 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, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:WRIGHT PLACE, THEFACILITY NUMBER:
415600267
ADMINISTRATOR:WRIGHT, JO ANNFACILITY TYPE:
740
ADDRESS:2525 ANNAPOLIS ST.TELEPHONE:
(650) 329-0911
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY: 6CENSUS: 4DATE:
08/13/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Fae GreenTIME COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with Fae Green.

During visit, LPA Marrufo toured the facility hallways and observed the facility hallways to be clear of obstructions. The rolling clothing hanger was no longer observed to be in the hallway.


No deficiencies were cited at this time as per California Code of Regulations Title 22.


This report was reviewed with Fae Green and a copy of the report was provided.
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2021
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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