<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019201434
Report Date: 03/20/2025
Date Signed: 03/20/2025 02:43:35 PM

Document Has Been Signed on 03/20/2025 02:43 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:ALONDRA CARE HOME 2FACILITY NUMBER:
019201434
ADMINISTRATOR/
DIRECTOR:		AYE, THINNFACILITY TYPE:
740
ADDRESS:36857 WALNUT STREETTELEPHONE:
(510) 509-4635
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 6CENSUS: 6DATE:
03/20/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Thinn AyeTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On this day at around 2 pm, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to verify corrections in connection with the pre-licensing inspection conducted on 3/6/2025. LPA met with Donna Caceres and explained the purpose of the visit. The Licensee/applicant arrived at the facility at 2:40pm.

During the visit, LPA observed a locked container for insulin in the refrigerator. LPA also verified the updated doctor's orders for one resident who has diabetes but unable to manage own insulin.

LPA observed that facility is ready to be licensed.

This report will be submitted to Central Applications Branch (CAB) and a final review of the application will be conducted. Additional requirements may still be required.

Exit interview conducted and a copy of this report were provided to the Licensee/Applicant.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Luisa Fontanilla
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1