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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600982
Report Date: 07/20/2022
Date Signed: 07/20/2022 11:24:54 AM

Document Has Been Signed on 07/20/2022 11:24 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:FOCUS DAY PROGRAM IIFACILITY NUMBER:
415600982
ADMINISTRATOR:RUIZ, YOLANDAFACILITY TYPE:
775
ADDRESS:575 PRICE AVENUETELEPHONE:
(650) 362-3990
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY: 60CENSUS: 12DATE:
07/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria VillacortaTIME COMPLETED:
11:30 AM
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On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management investigation visit to deliver the exclusion letter regarding a staff person (S1). LPA met with lead staff person Maria Villacorta and explained purpose of today's visit.

LPA met with Maria in private and explained purpose of the letter being delivered today. Maria confirmed that S1 had resigned back in March of 2022. His last day was March 31, 2022 and he has not returned to this day program since. LPA made observations of the four restrooms in the facility with Maria. There were no suspicious observations made.

Report is reviewed with Maria.

No citations issued on this day.
SUPERVISORS NAME: Julio Montes
LICENSING EVALUATOR NAME: Jaime Vado
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2022
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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