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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600802
Report Date: 04/04/2024
Date Signed: 04/04/2024 03:15:13 PM


Document Has Been Signed on 04/04/2024 03:15 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:PRECIOUS CARE HOMEFACILITY NUMBER:
415600802
ADMINISTRATOR:BONIFACIO, JOANNFACILITY TYPE:
740
ADDRESS:904 87TH STREETTELEPHONE:
(650) 992-2878
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY:6CENSUS: DATE:
04/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:No oneTIME COMPLETED:
03:12 PM
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On April 4, 2024 at 2:30pm, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the facility closure. LPA Calandra rang the doorbell twice and knocked on the door twice but no one came to the door. LPA Calandra observed through a window in the door COVID-19 signs on an interior wall to the left of the door and the Ombudsman phone number to the right. Across the hall from the door was a collage of presumably resident photographs and the LPA could see a couch, coffee table and locked file cabinet in a room facing the front door. LPA Calandra could not look into any other windows as all windows had curtains that were closed. No vehicles were observed in the driveway. LPA Calandra attempted to go to the backyard but could not find any latches for the gates on either side of the facility. LPA Calandra called Licensee/Administrator Joann Bonifacio and explained the purpose of his visit and asked if she could meet him at the facility. Joann stated that she had a meeting at the RO tomorrow and that she could not make it to the facility today. Joann also stated that she did not have keys to the facility and that she would need to have one made.

LPA Calandra knocked on seven neighbors doors. Only one neighbor answered the door. LPA Calandra introduced himself and asked if the neighbor had seen anyone at the facility recently. The neighbor stated they thought the facility had closed as they hadn't seen anyone in a couple of months. The neighbor stated usually on Wednesdays we put out our garbage cans here and I used to see them do it all the time but I haven't in awhile. The neighbor also recalled seeing "an old gentleman cutting the hedges" a few times but couldn't recall the last time they had seen him.

As Licensee/Administrator, Joann Bonifacio was unable to meet the LPA at the facility this report is unsigned.
SUPERVISOR'S NAME: Cara SmithTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: John CalandraTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024
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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