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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200848
Report Date: 01/22/2025
Date Signed: 01/22/2025 02:44:46 PM

Document Has Been Signed on 01/22/2025 02:44 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:FREMONT RTRMT COM-HAPPY LVNG BY COGIR/COGIR FREMONFACILITY NUMBER:
019200848
ADMINISTRATOR/
DIRECTOR:		KABADI, SANJAY PFACILITY TYPE:
740
ADDRESS:2860 COUNTRY DRIVETELEPHONE:
(510) 790-1645
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 40CENSUS: 36DATE:
01/22/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Salvador Gomez, Senior Executive Director TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 01/22/2025 at 1:17 PM Licensing Program Analysts (LPAs) P.Manalo and L. Fontanilla conducted an unannounced Case Management visit. LPAs met with Senior Executive Director, Salvador Gomez, and explained the purpose of the visit.

The Case Management visit was conducted due to renovations/upgrades observed at the facility's physical plant. Based on the interview conducted with the Senior Executive Director, he stated that they are doing exterior renovations such as upgrading patios, balconies, and painting exterior walls which began in April of 2024 and will be approximately completed May of 2025. Senior Executive Director stated that this renovation is conducted in phases in which it takes about 3-4 weeks per section of the building.

Senior Executive Director does not know whether CCLD was notified of the renovations.

LPAs requested to have the following documents such as building permit and plan of the renovations and have the facility sent to CCLD.




SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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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