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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015202448
Report Date: 09/21/2021
Date Signed: 09/22/2021 09:25:51 AM

Document Has Been Signed on 09/22/2021 09:25 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:A BETTER WAY, INC.FACILITY NUMBER:
015202448
ADMINISTRATOR:SHAHNAZ MAZANDARANIFACILITY TYPE:
726
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 6CENSUS: 2DATE:
09/21/2021
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Assumpta Kamanzi Permanency Director and Pete Maspaitella- Consultant TIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Christopher Rollins made an unannounced required Annual inspection at A Better Way Administrative office. LPA met with Assumpta Kamanzi- Permanency Director (PD) and Pete Maspaitella Consultant. The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents.

At 10:55 AM, LPA did a walk through inspection with PD and consultant of the office. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their front lobby. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with PD and consultant about the residential unit. DP stated that the residential home has toilets, sinks and tubs all in working order. PD states that all disinfectants and cleaning supplies are locked up and inaccessible. DP notified LPA that the program provides all participants with household essentials and that there are no weapons or firearms stored in the housing units. DP states that the home is at a comfortable temperature.

At 12:20 PM, LPA reviewed 2 participants files and 4 staff files with PD and Consultant. LPA observed 2 Participants files to be complete and found no deficiencies. All documents are complete and up to date. LPA observed 4 staff files to be complete, all documentation is up to date and all staff training were up to date/current.
SUPERVISORS NAME: Zaid Hakim
LICENSING EVALUATOR NAME: Christopher Rollins
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2021
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: A BETTER WAY, INC.
FACILITY NUMBER: 015202448
VISIT DATE: 09/21/2021
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During inspection, LPA requested a updated copy of the LIC 500 Personnel Report, LIC 610 C to maintain their file current. LPA receive an updated copy of updated Leasing Agreement. LPA also spoke with PD and Consultant about updating the Program Administrator documents. A review of Licensing Information System on September 21, 2021 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances.

Per Title 22 Regulations, no deficiencies were cited during this inspection.
Exit interview conducted and a copy of the report was left at the facility
SUPERVISORS NAME: Zaid Hakim
LICENSING EVALUATOR NAME: Christopher Rollins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
LIC809 (FAS) - (06/04)
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