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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600267
Report Date: 07/24/2024
Date Signed: 07/24/2024 12:02:44 PM

Document Has Been Signed on 07/24/2024 12:02 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/
DIRECTOR:
WRIGHT, JO ANNFACILITY TYPE:
740
ADDRESS:2525 ANNAPOLIS ST.TELEPHONE:
(650) 329-0911
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY: 6CENSUS: 1DATE:
07/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:JoAnn WrightTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Administrator JoAnn Wright.

During visit, LPA toured the facility inside and out. LPA toured the kitchen and pantry areas and 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 observed knives stored in a high shelf. During visit, Administrator placed the knives in a locked storage area in the garage.

LPA toured 2 out of 2 resident bathrooms. Each bathroom had available soap and paper towels and working lights. The water temperatures in the bathroom sinks measured at 108 F and 105 F.

LPA tested 1 out of 1 carbon monoxide detector and it functioned properly when tested. LPA tested 2 out of 2 hallway smoke detectors and each smoke detectors in the 5 out of 5 resident bedrooms. 1 out of the 2 hallway smoke detectors did not function when tested and the 5 out of 5 smoke detectors in the resident bedrooms functioned properly when tested.

LPA toured the outside area and found the outdoor exit to be clear of obstructions. LPA reviewed the Centrally Stored Medication and Destruction Record and resident record for 1 out of 1 resident and the staff record for 1 out of 1 staff and found them to be complete.

Advisory Notes were issued. See LIC9102 for more information. No deficiencies were cited as per California Code of Regulations Title 22. This report was reviewed with Administrator JoAnn Wright and a copy of this report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2024
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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