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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435201970
Report Date: 08/21/2024
Date Signed: 08/21/2024 11:09:17 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 08/21/2024 11:09 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:VINIART CARE HOMEFACILITY NUMBER:
435201970
ADMINISTRATOR/
DIRECTOR:		CLARIDAD, MARIA CECILIAFACILITY TYPE:
735
ADDRESS:689 KIRK GLEN DRIVETELEPHONE:
(408) 254-4709
CITY:SAN JOSESTATE: CAZIP CODE:
95133
CAPACITY: 6CENSUS: 5DATE:
08/21/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Maria Cecilia ClaridadTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management - Annual Continuation visit and met with Administrator (ADM) Maria Cecilia Claridad.

During visit, LPA Marrufo reviewed 5 out of 5 resident Personal and Incidental Money Logs and found them to be balanced. LPA reviewed 5 out of 5 resident Centrally Stored Medication and Destruction Records and found them to be complete. LPA reviewed 5 out of 5 resident records and 5 staff records and found them to be complete.

The Emergency Disaster Drill Log states the last recorded drill occurred on 04/05/2024.

During visit, LPA Marrufo observed the plank of wood on the facility fence that was loose during the visit on 08/20/2024 to be fixed.

No deficiencies were cited at this time as per California Code of Regulations Title 22.

This report was reviewed with Administrator Maria Cecilia Claridad and a copy of this report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/21/2024
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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