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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 419210070
Report Date: 03/06/2025
Date Signed: 03/06/2025 12:27:06 PM

Document Has Been Signed on 03/06/2025 12:27 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:SVS DALY CITY SKILLS CENTERFACILITY NUMBER:
419210070
ADMINISTRATOR/
DIRECTOR:
ALEJANDRA DUENASFACILITY TYPE:
775
ADDRESS:312 90TH STREETTELEPHONE:
(650) 757-4977
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY: 60CENSUS: 36DATE:
03/06/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:05 AM
MET WITH:Administrator, Alejandra DuenasTIME VISIT/
INSPECTION COMPLETED:
12:38 PM
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On March 6, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection visit. LPA met with Administrator, Alejandra Duenas and explained the purpose of the visit.

LPA toured the facility including but not limited to; all activity rooms, common areas, kitchen and dining room. The indoor and outdoor passageways were free of obstruction. No accessible bodies of water of fire safety hazards were observed. LPA observed clients doing activities; arts & crafts, exercising, playing games, etc. LPA observed clients also eating lunch.

A comfortable temperature was maintained and lighting was sufficient for comfort. Hot water throughout the facility measured between 106-114 degrees F. First aid kit was observed to be present. Bathrooms were observed to be in good repair. Changing rooms are equipped with changing tables and supply of incontinent items. According to the Administrator, clients bring food from their home, however can use the kitchen to store their lunches or use the microwave to warm up their food.

Emergency drills are being conducted and logged monthly. Carbon monoxide detectors were observed to be in working condition. LPA checked all fire extinguishers which were inspected on 07/2024.

There are currently no clients at the facility that take medication at the program. LPA reviewed 5 client files and 5 staff files. Client records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement.

No deficiencies are issued during the visit. Report is reviewed with the Administrator and a copy is provided.
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Komal Charitra
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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