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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415601167
Report Date: 01/22/2024
Date Signed: 01/22/2024 02:19:50 PM

Document Has Been Signed on 01/22/2024 02:19 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: 6DATE:
01/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Facility Manager - Crisel OnateTIME COMPLETED:
02:25 PM
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On 01/22/2024, Licensing Program Analysts (LPA) Jaime Vado and John Calandra conducted an uannounced case management - other visit. LPA met with facility manager Crisel Onate and explained the purpose of today's visit.

LPAs delivered an immediate exclusion letter to exclude a staff who worked in the facility. According to Crisel the staff member has not worked in the facility for several months.

The letter was given to and reviewed by the facility manager Crisel.

This report is reviewed and discussed, and a copy is provided today.
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Jaime Vado
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2024
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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