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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600982
Report Date: 08/06/2024
Date Signed: 08/06/2024 11:38:14 AM

Document Has Been Signed on 08/06/2024 11:38 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:FOCUS DAY PROGRAM IIFACILITY NUMBER:
415600982
ADMINISTRATOR/
DIRECTOR:		RUIZ, YOLANDAFACILITY TYPE:
775
ADDRESS:575 PRICE AVENUETELEPHONE:
(650) 362-3990
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY: 60CENSUS: 60DATE:
08/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Maria VillacortaTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 8/6/2024, Licensing Program Analysts (LPAs) Grace Donato & Kiran Jain conducted an unannounced annual visit. LPAs met with Program Director, Maria Villacorta and explained the purpose of the visit.

LPAs toured facility and grounds. No accessible bodies of water observed. There are 6 activity/classroom areas. Rooms were observed to be clean and spacious. Clients were observed to be participating in group activities. LPAs observed 4 single bathrooms to be clean and odor-free. Changing room was observed to be clean and odor-free. Kitchen is locked but accessible to clients if staff is around. Lunches are brought in by clients from their respective homes. Sharps were observed to be stored appropriately and inaccessible to clients. Staff break room was observed to be locked. No medications in the facility.

LPAs checked all fire extinguishers which were inspected on 5/2024. Carbon monoxide detectors were observed to be in working condition. First aid kit was observed to be present. LPA reviewed facilities emergency disaster plan. Five client files and five staff files were reviewed and all records were up to date and current.

The following updated forms were received:
-LIC308 Designation of Administrative Responsibility
-LIC500 Personnel Report
-LIC610D Emergency Disaster Plan

No deficiencies are cited at this time. Report is reviewed and a copy is provided.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
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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