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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202666
Report Date: 02/20/2025
Date Signed: 02/21/2025 08:39:34 AM

Document Has Been Signed on 02/21/2025 08:39 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:TOUCH OF LIFE RESIDENTIAL CARE FACILITY INCFACILITY NUMBER:
435202666
ADMINISTRATOR/
DIRECTOR:		DEVANO, BELINDAFACILITY TYPE:
740
ADDRESS:2748 ASHLEY CTTELEPHONE:
(408) 854-0735
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
02/20/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:05 PM
MET WITH:Belinda Devano, Administrator (ADM)TIME VISIT/
INSPECTION COMPLETED:
01:55 PM
NARRATIVE
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On February 20, 2025, at 1:05 PM, Licensing Program Analysts (LPAs) Kenneth Madrigal and Mita Partoza, arrived at the facility unannounced to conduct a case management visit. The purpose of the visit is to hand deliver an immediate exclusion letter for an individual (S1) who the Department determined engaged in conduct inimical at another licensed facility. LPAs met with Belinda Devano, Administrator (ADM) and stated the purpose of the visit and handed the letter to ADM.

Upon arrival, S1 opened the facility door and identified themselves to LPAs. Three staff members and five residents are observed to be in the facility. At the time of the visit, the Order to Individual of Immediate Exclusion letter was hand delivered to S1. S1 acknowledged receipt of the Immediate Exclusion Letter.
ADM stated S1 will be removed from the staff roster and Guardian. LPAs requested a copy of the updated LIC 500.

ADM and LPAs requested S1 to leave the facility and S1 complied. LPAs observed S1 leave the facility.

No deficiencies were cited during today’s visit per California Code of Regulations, Title 22.

This report was reviewed with Belinda Devano, Administrator, and a copy of the report was provided.

END OF REPORT. Page 1 of 1.
Jackie JinTELEPHONE: (714) 319-3786
Kenneth MadrigalTELEPHONE: (669) 660-1606
DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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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