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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486804109
Report Date: 03/24/2025
Date Signed: 03/24/2025 03:24:25 PM

Document Has Been Signed on 03/24/2025 03:24 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:ALL QUALITY HOME CARE SERVICES, LLCFACILITY NUMBER:
486804109
ADMINISTRATOR/
DIRECTOR:		CARO, MARVINFACILITY TYPE:
735
ADDRESS:170 TERI CTTELEPHONE:
(510) 230-9897
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY: 4CENSUS: 0DATE:
03/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH:Marvin Caro, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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At approximately 1:40 PM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by Marvin Caro, Administrator. Facility is an Adult Residential Facility (ARF) with zero (0) clients in care. Facility is serviced by vendor North Bay Regional Center (NBRC).

At approximately 1:50 PM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one-story home, was a comfortable temperature, and passageways were free from obstructions. Facility's fire extinguisher was observed charged and was last serviced 1/2025. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperatures will be within the allowable range of 105 to 120 degrees F per Title 22 regulations upon clients moving in. LPA observed a supply of clean linens, hygiene, and paper products available for clients. Clients' bedrooms were inspected and observed to be move-in ready with all the appropriate furnishings as outlined in Title 22 regulations. Cabinets that will contain cleaning supplies and other items that could pose a risk have locks. Facility understands that on the first day of any clients moving in, they shall replenish their supply of perishable and non-perishable foods, as well as emergency water supply, as required by Title 22 Regulations.

Facility shall conduct monthly disaster drills. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. Administrator understands paperwork requirements for all residents including but not limited to physicians reports, TB Testing, and Pre-appraisals. Administrator also understands the paperwork requirements for staff including but not limited to First Aid/CPR, Health Screening/TB, Training Hours, and Personnel Records.

Continued on LIC809C...
NAME OF LICENSING PROGRAM MANAGER: Victoria Bertozzi
NAME OF LICENSING PROGRAM ANALYST: Elias Magdaleno
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: ALL QUALITY HOME CARE SERVICES, LLC
FACILITY NUMBER: 486804109
VISIT DATE: 03/24/2025
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Continued from LIC809...



Updated copies of the following documents are to be submitted to CCL within 30 days of this visit:

Updated Administrator Certificate
LIC500 - Personnel Report (updated)
LIC308- Designation of Responsibility
LIC610D - Emergency Disaster Plan (updated)


No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.
NAME OF LICENSING PROGRAM MANAGER: Victoria Bertozzi
NAME OF LICENSING PROGRAM ANALYST: Elias Magdaleno
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2025
LIC809 (FAS) - (06/04)
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