Facility Evaluation Report

FCSN East Bay Adult Day Program, Fremont10/18/2024Licence 019200199

Capacity105
Census19
Date signed10/18/2024 02:58:35 PM
The inspector’s account

On 10/18/2024 at 11:15 AM, Licensing Program Analysts (LPAs) P. Manalo and J. Clancy-Czuleger arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Program Director, Vivian Largusa, and explained the purpose of the visit.

LPA toured facility with Program Director including but not limited to, multiple activity rooms, kitchen, bathrooms, office space, and the outside recreational area. Clients bring their own lunches and snacks. Emergency supplies were observed. The hot water temperature in the client bathroom measured 116.3 degrees Fahrenheit. There are no bodies of water or fire safety hazards observed. Restrooms are maintained in safe and in sanitary operating condition, and additional equipment for the physically handicapped was observed.

At 12:45 PM, 6 of clients records were reviewed. At 1:35 PM, 4 staff records were reviewed and 4 of 4 have current first aid training and 4 of 4 associated to the facility. Fire extinguishers throughout facility were last inspected 02/14/2024. First aid kit was checked.

At 12:15 PM, LPAs observed Lock Dry Lubricant was found on the kitchen counter.

At 12:18 PM, LPAS observed twine and bowl filled with craft supplies was on top of the stove.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.

The following forms to be updated and submitted to CCL by 10/25/2024:

LIC 308 Designation of Administrative Responsibility

Exit interview conducted with Program Director. Appeal Rights and a copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction