Senior Care Records.

Facility Evaluation Report

Serene Haven Home, South San Francisco10/25/2024Licence 415601183

Capacity4
Census0
Date signed10/25/2024 09:18:42 AM
The inspector’s account

On 8/15/24, Licensing Program Analyst (LPA) Grace Donato conducted an announced Pre-Licensing Inspection visit. LPA met with Administrator, Bill Fajardo & Claire Ascalon.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA observed the indoor and the outdoor passageways are free of obstruction. Facility is single level with 4 rooms. All rooms are observed with required furniture and lighting, bathrooms are odor-free and in good repair and have grab bars. Emergency food supply is observed.

Facility lighting is sufficient for comfort and safety. LPA toured the kitchen area and observed it to be clean. Facility refrigerator & freezer temperatures are within regulatory standards. Chemicals & sharps have their own locked storage in the garage. All fire prevention systems such as smoke detectors, carbon monoxide detector, fire extinguishers have been inspected in place.

Component III is also conducted on this day.

Facility is clean and in good repair based on observations made today. Facility is in compliance with Title 22 regulations. No citations are issued.

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