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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200938
Report Date: 03/05/2025
Date Signed: 03/05/2025 04:36:13 PM

Document Has Been Signed on 03/05/2025 04:36 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:SILVERADO SENIOR LIVING-BERKELEYFACILITY NUMBER:
019200938
ADMINISTRATOR/
DIRECTOR:		EMORUWA, JEFFREY OFACILITY TYPE:
740
ADDRESS:2235 SACRAMENTO STREETTELEPHONE:
(949) 240-7200
CITY:BERKELEYSTATE: CAZIP CODE:
94702
CAPACITY: 90CENSUS: 76DATE:
03/05/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Jeffrey Emoruwa, AdministratorTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 03/05/2025 around 12:00 PM, Licensing Program Analyst (LPA) L. Holmes conducted an unannounced Required 1 Year inspection. LPA met with Jeffrey Emoruwa, Administrator and explained the purpose of the visit. LPA toured the facility with ADM who currently holds a certificate (#7016762740) that expires on 08/05/26. The facility’s fire clearance was approved for ninety (90) non-ambulatory residents; sixty-two (62) may be bedridden.

Upon arrival LPA observed two (2) staff attending to the residents that were interacting and congregating in the common area of the facility. LPA, ADM and S5 toured the facility including, but not limited to bathrooms, shower room, common areas, medication room/nursing station, laundry room, dining areas and courtyard. The facility consists of individual apartments style rooms housed by the residents. Residents were exercising, playing the piano and listening to music. All outdoor and indoor passageways were free of obstruction. There were not any bodies of water. A comfortable temperature was maintained at 72 degrees Fahrenheit (F). LPA observed lighting in all areas to be adequate for the comfort and safety of the residents. Hot water temperature in the shared residents' bathroom was measured at 113 degrees (F). All toilets, hand washing, and bathing areas were safe, sanitary and in operating condition. Hand washing signs, paper towels, and soap observed at all hand washing stations. Linen and hygiene products were available for all residents. PPE, sanitizer, and paper goods remain sufficient.

...continued on LIC9099C.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: SILVERADO SENIOR LIVING-BERKELEY
FACILITY NUMBER: 019200938
VISIT DATE: 03/05/2025
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...continued from LIC9099.

The facility is masking per City of Berkeley's Public Health recommendations. Smoke detectors and carbon monoxide units were in operating condition during visit. Fire extinguishers were observed full and last inspected 05/13/2024. Emergency Disaster Plan is updated. Safety drill was conducted last quarter by Safety First.

Five (5) staff records were reviewed, and all staff have criminal record clearances. Seven (7) residents records were reviewed and are complete.

The following forms are to be updated and submitted to CCLD:
-Resident Roster
-LIC500 Personnel Report
-LIC308 Designation of Administrative Responsibility (Reviewed)
-LIC610 Emergency Disaster Plan (Reviewed)
-An updated copy of Administrator Certificate(s) (Reviewed)
-Liability Insurance

No deficiencies cited during visit.

Exit interview conducted and a copy of this report provided to Jeffrey Emoruwa, Administrator
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC809 (FAS) - (06/04)
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