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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600267
Report Date: 08/18/2022
Date Signed: 08/18/2022 03:25:27 PM

Document Has Been Signed on 08/18/2022 03:25 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
CENTRAL COAST CR/RES, 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: 3DATE:
08/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Jo Ann WrightTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Administrator Jo Ann Wright.

During visit, LPA Marrufo toured the facility. LPA Marrufo observed there to be a visitor screening form and thermometer available to screen visitors. LPA Marrufo observed there to be a PPE supply of at least 30 days. LPA Marrufo observed there to be a perishable food supply of at least 2 days and a non-perishable food supply of at least 7 days. LPA Marrufo observed there to be available cleaning supplies.

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

This report was reviewed with Administrator Jo Ann Wright and a copy of the report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2022
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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