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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200873
Report Date: 04/28/2023
Date Signed: 04/28/2023 04:25:00 PM

Document Has Been Signed on 04/28/2023 04:25 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:POINT AT ROCKRIDGE, THEFACILITY NUMBER:
019200873
ADMINISTRATOR:KNOX, KATHLEEN LFACILITY TYPE:
740
ADDRESS:4500 GILBERT STREETTELEPHONE:
(510) 658-9266
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY: 186CENSUS: 126DATE:
04/28/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Stephanie Brice, AdministratorTIME COMPLETED:
04:35 PM
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On 4/28/23 at 3:30 p.m., Licensing Program Analyst (LPA) Greg Clark conducted an unannounced case management visit as a result of this facility receiving 11 residents from Vista Terrace of Belmont (VTB). LPA met with Stephanie Brice, Administrator and explained the purpose of the visit.

During the visit, LPA interviewed facility administrator and 1 resident (R1) from VTB. R1 stated that she felt safe, the facility is beautiful and that her needs were being met. Remaining residents are due at the facility around 5 p.m. Beds are due to arrive between 7 and 8 p.m.

LPA confirmed that a total of 11 residents from VTB will be moving to this facility. Facility staff will be providing care and supervision of the residents from VTB today, agency staff (The Key) will be providing care, in addition to facility staff, over the weekend.

There was no imminent health/safety concerns on today's date. LPA will return to the facility tomorrow to confirm arrival of beds, belongings and that staffing is covered.

Exit interview conducted and copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE: DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2023
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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