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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435201992
Report Date: 03/24/2023
Date Signed: 03/24/2023 04:31:48 PM


Document Has Been Signed on 03/24/2023 04:31 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
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131



FACILITY NAME:TOUCH OF LIFE CARE HOMEFACILITY NUMBER:
435201992
ADMINISTRATOR:SHEILA ALDAFACILITY TYPE:
740
ADDRESS:3318 CERRITO COURTTELEPHONE:
(408) 528-7137
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY:6CENSUS: 0DATE:
03/24/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:22 PM
MET WITH:Sheila AldaTIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA) Steve Chang conducted an unannounced Case Management visit, and met with Administrator (ADM) Sheeila Alda and staff Dario Alda (S1).

During today’s visit, LPA met with Staff (S1). LPA addressed the purpose of today's visit. S1 stated the facility has no residents in care, and is in non operational status.

LPA spoke with ADM on the phone. ADM stated the facility was closed since October 2022. ADM requested to speak with Licensing Program Manager (LPM) Romeo Manzano on the phone. ADM confirmed with LPM that the facility has been non-operational and is no longer interested to operate RCFE facility. ADM stated that facility has been closed effective 10/2022.

LPM/LPA informed ADM to send a letter to licensing on or before 3/27/2023.

Exit interview was conducted with S1. A copy of today’s report is provided to S1.
SUPERVISOR'S NAME: Romeo ManzanoTELEPHONE: (408) 324-2112
LICENSING EVALUATOR NAME: Chihhsien ChangTELEPHONE: (408) 904-9843
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2023
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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