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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600964
Report Date: 08/16/2022
Date Signed: 08/16/2022 11:57:07 AM


Document Has Been Signed on 08/16/2022 11:57 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
SF COASTAL AC/SC, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:KENSINGTON PLACE REDWOOD CITYFACILITY NUMBER:
415600964
ADMINISTRATOR:GREIG O'CONNORFACILITY TYPE:
740
ADDRESS:2800 EL CAMINO REALTELEPHONE:
(650) 363-9200
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY:67CENSUS: 52DATE:
08/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Joan NewmanTIME COMPLETED:
12:00 PM
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On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management inspection visit in response to a notification made to the Department regarding concerns of facility funds. LPA met with current administrator Joan Newman and explained the purpose of today's visit.

The facility self reported to the Department where a previous staff member misused a corporate credit card. This was discovered by the licensee when a reconciliation of financial records were being reviewed. This instance was not at the fault of the facility and was an isolated incident that occurred over a span of time conducted by the previous staff member who is no longer employed at this facility.

On this day LPA Vado is delivering in person an Immediate Exclusion Letter identifying the previous staff person whose conduct was inimical triggering the exclusion based on the previous actions of this staff member.

No citations issued.

Report is reviewed with the current administrator Joan Newman.
SUPERVISOR'S NAME: Jackie JinTELEPHONE: (714) 319-3786
LICENSING EVALUATOR NAME: Jaime VadoTELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:
DATE: 08/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/16/2022
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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