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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415601092
Report Date: 12/29/2021
Date Signed: 12/29/2021 12:08:51 PM

Document Has Been Signed on 12/29/2021 12:08 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ALEXEI'S HOMEFACILITY NUMBER:
415601092
ADMINISTRATOR:FLORES, VICTORIAFACILITY TYPE:
735
ADDRESS:140 OAKFIELD AVENUETELEPHONE:
(650) 307-3607
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 3CENSUS: DATE:
12/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Tess DeguzmanTIME COMPLETED:
12:15 PM
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On December 29, 2021, Licensing Program Analyst (LPA) Komal Charitra intended to conduct an annual control inspection at Oakfield Manor LLC. LPA was greeted by Caregiver, Tess Deguzman and Administrator, Victoria Flores, joined shortly thereafter. It was brought to LPA's attention that Oakfield Manor LLC went through a change of ownership. The facility address: 140 Oakfield Avenue, Redwood City, CA 94061 was Oakfield Manor LLC and currently is Alexei's Home.

On September 11, 2020, another LPA conducted a Pre-Licensing for the new facility: Alexei's Home with Administrator, Victoria Flores. LPA was notified that there was an annual inspection conducted on September 28, 2021.

LPA reviewed report with Administrator, Victoria Flores and a copy is provided.
SUPERVISORS NAME: Julio Montes
LICENSING EVALUATOR NAME: Komal Charitra
LICENSING EVALUATOR SIGNATURE: DATE: 12/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/29/2021
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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