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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502700117
Report Date: 04/17/2023
Date Signed: 04/17/2023 12:30:05 PM

Document Has Been Signed on 04/17/2023 12:30 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:STEPS HOMEFACILITY NUMBER:
502700117
ADMINISTRATOR:VICTOR MANUEL CARDONAFACILITY TYPE:
735
ADDRESS:560 ASHLAND AVENUETELEPHONE:
(415) 652-6720
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY: 5CENSUS: DATE:
04/17/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Victor CardonaTIME COMPLETED:
12:45 PM
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On 4/17/23 at approximately 11:20am Licensing Program Analysts (LPAs) Maja Jensen and Jennifer Fain arrived at facility unannounced to conduct a case management related to complaint # 27-AS-20230227155002 . LPA Jensen met with Licensee Victor Cardona and explained the purpose of todays visit.

Under complaint # 27-AS-20230227155002, the Licensee was cited for a Personal Rights violation in relation to using Personal and Incidental (P&I) funds to pay for a portion of the cost of a window replacement. The Plan of Correction was established as the following:

Licensee agrees to immediately cease the use of P&I funds for property destruction and allow for opportunity for a client and any conservator if applicable to dispute charges levied against them. Licensee will email and attestation that this regulation has been reviewed, is understood and will be complied with to maja.jensen@dss.ca.gov.

Upon further review the Department has also determined the Licensee is required to refund $200 in P&I funds to the resident by May 1, 2023 and will email LPA Jensen evidence of refund provided via email to maja.jensen@dss.ca.gov. Refunding the P&I funds does not preclude the Licensee from billing the resident for any damages that they have determined to be reimbursable.

An exit interview was conducted and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2023
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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