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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435201522
Report Date: 07/17/2024
Date Signed: 07/17/2024 12:09:45 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/17/2024 12:09 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:SOCIAL VOCATIONAL SERVICES, INC.FACILITY NUMBER:
435201522
ADMINISTRATOR/
DIRECTOR:		PERKINS, CYNTHIAFACILITY TYPE:
775
ADDRESS:471 GIANNI STREETTELEPHONE:
(408) 727-3370
CITY:SANTA CLARASTATE: CAZIP CODE:
95054
CAPACITY: 60CENSUS: 30DATE:
07/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Program Director, Ruby DuranTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with Program Director, Ruby Duran and stated the purpose of today's visit. The facility has 13 staff and 30 clients at the facility today.

During visit, LPA Rai toured the facility inside and out. Exit doors were cleared of obstruction. Sharps and chemicals were locked in secured areas.

The facility restrooms had available soap, paper towels and hand sanitizer. Hot water temperature in the bathroom sink was measured range of 103.5 degrees F - 104.5 degrees F. Exercise equipment was also observed. Refrigerators were available to store clients' food in the kitchen area.

Fire extinguisher was observed and inspected on 05/01/2024. Facility smoke detectors and carbon monoxide detectors were in working condition. The facility's sprinklers were inspected by a third party vendor on 5/7/2024 and passed the inspection. First aid kits were inspected and observed compliant with required regulations. The disaster drills was conducted on 4/10/2024, 5/20/2024, and 6/20/2024.

LPA Rai reviewed facility records for 5 staff and 5 clients.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Program Director, Ruby Duran and a copy of the report was provided.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2024
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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