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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600870
Report Date: 03/06/2025
Date Signed: 03/06/2025 10:48:50 AM

Document Has Been Signed on 03/06/2025 10:48 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SWEETWOOD HOMEFACILITY NUMBER:
415600870
ADMINISTRATOR/
DIRECTOR:
ROBERTO BALAUROFACILITY TYPE:
735
ADDRESS:1311 SWEETWOOD DRIVETELEPHONE:
(650) 703-1217
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY: 4CENSUS: 4DATE:
03/06/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Administrator, Roberto BalauroTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On March 6, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrator, Roberto Balauro and explained the purpose of the visit.

LPA toured the inside and outside of the facility, including but not limited to; all client rooms, living room, dining room, bathrooms & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. There are four client rooms, all of which were single private rooms with required furnishings. LPA observed two full bathrooms to be clean, odor-free and in good repair. Water temperature throughout the facility measured between 111-116 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete.

Dining room and living room were free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed two day perishables and seven day non-perishables.
Medications, sharps, and chemicals were observed locked an inaccessible to clients in care.

Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of May 2024. Emergency drills are logged and done every month. LPA reviewed 4 client records and 5 staff records. Client records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

No citations are issued during this visit. Report is reviewed with the Administrator and a copy is provided.
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Komal Charitra
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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