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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600898
Report Date: 04/26/2024
Date Signed: 04/26/2024 12:52:48 PM

Document Has Been Signed on 04/26/2024 12:52 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:OASIS DAY PROGRAMFACILITY NUMBER:
415600898
ADMINISTRATOR/
DIRECTOR:
MONTIEL, ALDOFACILITY TYPE:
775
ADDRESS:230 GRAND AVENUETELEPHONE:
(415) 407-6588
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 30CENSUS: 27DATE:
04/26/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:18 AM
MET WITH:LInda Moreno & Aldo MontielTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 4/26/24 LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Program Supervisor, Linda Moreno and Program Director Aldo Montiel. LPA explained the purpose of the visit.

LPA toured the facility including all of activity rooms, common areas & kitchen. The indoor and outdoor passageways were free of obstruction. LPA observed clients doing activities in the main room, some clients getting some rest in the private rooms. While touring the facility it was observed that the room temperature was at 66 deg F. Hot water was also tested in the bathrooms and the temperature was 108 deg F. All fire extinguishers have been checked and current. Client bathrooms were observed to be in good repair equipped with grab bars. Food are brought in by residents prepared from their home facilities. Snacks are provided. Chemicals are in locked cabinets. Laundry room is also locked. Emergency drills are done once a month.

Five client records and five staff records were reviewed. Resident records are updated, complete and signed. Staff records are complete, with training logs. Facility has a certified administrator on site

No deficiencies are cited at this time. Report is reviewed and a copy is provided.
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2024
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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