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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502700117
Report Date: 05/10/2024
Date Signed: 05/10/2024 12:13:52 PM

Document Has Been Signed on 05/10/2024 12:13 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:STEPS HOMEFACILITY NUMBER:
502700117
ADMINISTRATOR/
DIRECTOR:		VICTOR MANUEL CARDONAFACILITY TYPE:
735
ADDRESS:560 ASHLAND AVENUETELEPHONE:
(415) 652-6720
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY: 5CENSUS: 5DATE:
05/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Tyrone Rush, HouseTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 05/10/24, Licensing Program Analysts (LPA's) Renee Campbell arrived to the facility unannounced to conduct an annual inspection. LPA Campbell met with, Tyrone Rush, House Manager and explained the purpose of the visit.  His administrator's certificate # 6070268735 is pending. The current census is 5 residents with 14 staff in all. 

The facility is licensed to serve 5 developmentally disabled, ambulatory residents, ages 18 to 59. The residence is a one story 5 bedroom building with an attached garage. The garage is used as a work out area for residents and for locked, inaccessible cleaning products A freezer is kept in the garage as well. LPA Campbell observed frozen food items with dates written on them. LPA Campbell also observed painting/craft supplies for residents. Outside of the garage door is a washer and dryer.

In the kitchen, several items were displayed on the refrigerator. They included, a daily temperature log for the refrigerator, emergency contacts for the community such as the fire department, staff work schedule, Local County Mental Health 24 hr Crises Intervention Phone Numbers and Mandated Reporter responsibilities. Menus for the facility were kept in a binder next to the refrigerator. Residents were required to initial meals to verify their selections.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: STEPS HOME
FACILITY NUMBER: 502700117
VISIT DATE: 05/10/2024
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The temperature for the refrigerator was observed to be -1 degrees Fahrenheit for the freezer and 40 degrees Fahrenheit for the refrigerator and in compliance.

Client bedrooms were found to have the required furnishings of a bed, lamp, drawers and night stand. The smoke/carbon monoxide alarms were tested and found to be functional. The fire extinguishers were last inspected on 01/05/2024. The temperature for the hot water in the bathroom was tested and found to be 105.6 degrees Fahrenheit and the thermostat was set at 68 degrees Fahrenheit.

A tour was conducted of the backyard. LPA Campbell observed a fenced in green yard surrounded by a concrete pathway. A resident garden and exit was found on one side and another exit was found on the other side of the yard. Both exits were accessible to residents.
Of the 5 residents in the facility, LPA Campbell reviewed 2 of their files. Of the 14 staff working for the facility, LPA Campbell reviewed 2 of their files.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024
LIC809 (FAS) - (06/04)
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