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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600870
Report Date: 03/29/2024
Date Signed: 03/29/2024 03:35:00 PM

Document Has Been Signed on 03/29/2024 03:35 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:SWEETWOOD HOMEFACILITY NUMBER:
415600870
ADMINISTRATOR:ROBERTO BALAUROFACILITY TYPE:
735
ADDRESS:1311 SWEETWOOD DRIVETELEPHONE:
(650) 703-1217
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY: 4CENSUS: 4DATE:
03/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:14 PM
MET WITH:Ionna Dale, Direct Support Professional and Roberto Balauro, AdministratorTIME COMPLETED:
03:45 PM
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On March 29, 2024 at 2:17 PM, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra met with Ionna Dale, Direct Support Professional(DSP) and explained the purpose of his visit. Roberto Balauro, Administrator arrived later during the visit.

LPA Calandra toured the physical plant. This is a 4 bedroom, 2 bathroom house with a front and backyard, living room, dining room, kitchen, and office. The facility was maintained at a comfortable of 67 degrees Fahrenheit. The fire extinguishers were observed to be fully charged and last checked on 5/17/2023. The Fire Alarms and Carbon Monoxide detector were observed to be in working order. No bodies of water, obstructions, or hazards were observed in the front yard, backyard, and hallways. The facility had the required 7 days of non-perishables and 2 days of perishables on site. No food was expired. The facility's washer and dryer were observed to be in good repair. Hot water temperature was measured at 138 degrees Fahrenheit. The Administrator, Roberto Balauro turned down the hot water temperature in the presence of the LPA.

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

LPA Calandra reviewed 4 client records. All were observed to be complete.

A Technical Violation was provided for having hot water temperature measuring above 125 degrees Fahrenheit.

No deficiencies were cited during today's visit.

The Annual inspection will be completed at a later date.

This report was reviewed with Roberto Balauro, Administrator and a copy of the report left at the facility.
SUPERVISORS NAME: Cara Smith
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2024
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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