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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202749
Report Date: 03/21/2025
Date Signed: 03/21/2025 01:44:08 PM

Document Has Been Signed on 03/21/2025 01:44 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:CARING HANDS RESIDENTIAL LIVING IIFACILITY NUMBER:
435202749
ADMINISTRATOR/
DIRECTOR:		OKORO, SYLVESTER OFACILITY TYPE:
740
ADDRESS:1324 BAGELY WAYTELEPHONE:
(614) 747-3443
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
03/21/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:05 PM
MET WITH:Staff Abijuan BurchellTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
NARRATIVE
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On March 21, 2025, Licensing Program Analyst Manuel Monter conducted an unannounced Case Management - Deficiencies visit. LPA met with Staff S1 Abijuan Burchell. LPA explained the purpose of the visit.

On January 16, 2025, the facility was cited the following type A deficiency, during an annual inspection, with the POC due of January 17, 2025. -- 87309 Storage Space and Access (a)

On January 17, 2025, the Department received plan of corrections and cleared plan of corrections on January 17, 2025.

On March 21, 2025, LPA conducted a follow up visit. LPA toured the facility inside and out. LPA did not observe any detergents or toxics accessible to residents in care. LPA observed the storage shed in the backyard locked.

While touring the home, LPA observed the door in the living room had a Tuut door lever lock, child proofing door handle, creating an obstruction to opening that door. (Photograph was taken). While touring the facility kitchen LPA observed the glass sliding screen door. LPA observed a stick blocking the path of the sliding screen door, creating an obstruction. (Photographs were taken.)

A deficiency is being cited during today's visit. This report was reviewed with Staff Abijuan Burchell and a copy of the signed report was provided.
Romeo ManzanoTELEPHONE: (408) 388-2297
Manuel MonterTELEPHONE: (408) 324-2112
DATE: 03/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2025
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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Document Has Been Signed on 03/21/2025 01:44 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: CARING HANDS RESIDENTIAL LIVING II
FACILITY NUMBER: 435202749

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/22/2025
Section Cited
CCR
87307(d)(6)

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87307 Personal Accommodations and Services(d) (6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.

This requirement was not met as evidenced by:
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ADM stated he will send a letter of understanding regarding the regulation.

ADM stated he will send photo documentation showing both the Tuut door lever lock, child proofing door handle and the stick in the kitchen have been removed.
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Based on observation, facility's kitchen, sliding screen door has a stick preventing the door from opening. LPA observed the door in the living room had a Tuut door lever lock creating an obstruction to opening that door. This poses an immediate health, safety or personal rights risk to persons in care.
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ADM stated he will send the plan of corrections to LPA by POC date, March 22, 2025.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Romeo ManzanoTELEPHONE: (408) 388-2297
Manuel MonterTELEPHONE: (408) 324-2112

DATE: 03/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2025

LIC809 (FAS) - (06/04)
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