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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415601186
Report Date: 11/15/2024
Date Signed: 11/15/2024 11:50:08 AM

Document Has Been Signed on 11/15/2024 11:50 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:MARIA'S SENIOR CARE HOMEFACILITY NUMBER:
415601186
ADMINISTRATOR/
DIRECTOR:
BARTOLI, MARIAFACILITY TYPE:
740
ADDRESS:419 TOPAZ STREETTELEPHONE:
(510) 378-2194
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94062
CAPACITY: 6CENSUS: 6DATE:
11/15/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:08 AM
MET WITH: Ronel Sangil, Caretaker and Maria Bartoli, Applicant TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On November 15, 2024, at 10:08 AM, Licensing Program Analyst(LPA) John Calandra, arrived at the facility to conduct an unannounced follow-up pre-licensing visit. LPA Calandra was greeted by Ronel Sangil, Caretaker and explained the purpose of the visit. Applicant, Maria Bartoli arrived later during the visit.

On 11/1/2024, LPA Calandra conducted the initial pre-licensing visit and found the following deficiencies:

-Place night lights in hallways
-Ensure water temperature is lowered to between 105 and 120 degrees Fahrenheit
-Fix tile on side of house
-Clear a pathway in Garage if needed for emergency evacuation
-Place a Thermometer in each fridge and freezer
-Place a Thermometer and Current edition of First Aid Manual approved by the American Red Cross, the American Medical Association, or a State or Federal Health Agency in the First Aid Kit
-Remove bed and frame in garage
-Ensure all door alarms are operational
-Ensure all resident and staff files have the required Licensing documents
-Fix faucet in bathroom between bedrooms 1 and 2
-Fix leaking dishwasher in Kitchen

On 11/14/2024, after the visit, Maria Bartoli notified LPA Calandra of the above deficiencies being resolved.

During the visit, LPA Calandra checked the hot water temperature which was measured at 107.8 degrees Fahrenheit.

As a result of today's inspection, the area of concerns from the initial inspection have been resolved.

Immediate Licensure is recommended, pending final approval from the Central Applications Unit.

This report was reviewed with Maria Bartoli, Applicant and a copy of the report left at the facility.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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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