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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415601167
Report Date: 12/12/2023
Date Signed: 12/12/2023 03:40:31 PM

Document Has Been Signed on 12/12/2023 03:40 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:MCGARVEY HOMEFACILITY NUMBER:
415601167
ADMINISTRATOR:RAPADAS, LILIBETHFACILITY TYPE:
735
ADDRESS:551 PARK WAYTELEPHONE:
(650) 580-1266
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 6CENSUS: 0DATE:
12/12/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:56 PM
MET WITH:Lilibeth RapadasTIME COMPLETED:
03:30 PM
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On 12/12/2023, Licensing Program Analyst (LPA) Grace Donato conducted an announced Pre-Licensing Inspection visit. LPA met with Administrator, Lilibeth Rapadas.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA observed the indoor and the outdoor passageways are free of obstruction. This is a single level facility with downstairs garage and rest area not accessible to residents. All rooms are observed with required furniture and lighting, bathrooms to be odor-free and in good repair and have grab bars. Water temperature was measured at 112F. Room temperature is at 68F.

Facility lighting is sufficient for comfort and safety. LPA toured the kitchen area and observed it to be clean and in good repair. Facility refrigerator temperatures are within regulatory standards. Chemicals and toxins were observed to be locked in the kitchen cabinets.

All fire prevention systems such as smoke detectors, carbon monoxide detectors, fire extinguishers have been inspected in place.

Facility is clean and in good repair based on observations made today. Facility is in compliance with Title 22 regulations. No citations are issued.

A copy of report is provided.
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2023
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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