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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415601167
Report Date: 12/03/2024
Date Signed: 12/03/2024 04:06:40 PM

Document Has Been Signed on 12/03/2024 04:06 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/
DIRECTOR:
RAPADAS, LILIBETHFACILITY TYPE:
735
ADDRESS:551 PARK WAYTELEPHONE:
(650) 580-1266
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 6CENSUS: 5DATE:
12/03/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:13 PM
MET WITH:Lilibeth RapadasTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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On 12/3/2024, LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Administrator, Lilibeth Rapadas and explained the purpose of the visit.

LPA toured the facility inside and outside including all of resident rooms and kitchen area. Residents are currently arriving one by one from day program. Facility ha 3 shared bedrooms and has a functioning elevator located in the kitchen area. While touring the facility it was observed that the room temperature was at 68 deg F. Hot water was also tested in the bathrooms and the temperature was 109 deg F. The facility is observed to be clean, odorless, and well maintained. Residents bedrooms were observed to be well organized and fully furnished with adequate lighting. Sharps and toxic materials were observed locked and inaccessible. Food supply was observed with an adequate two day perishable and seven day non-perishable food supply. Carbon monoxide/smoke detectors, and fire extinguisher were present throughout the facility. Facility has an updated log for emergency drill which is done quarterly.

Five resident records and five staff records were reviewed. Centrally stored medication logs are complete and updated.

LPA received Administrator certificate and Personnel report.

No deficiencies cited today. Report is reviewed and copy is provided.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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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