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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601557
Report Date: 11/25/2024
Date Signed: 11/25/2024 04:07:33 PM

Document Has Been Signed on 11/25/2024 04:07 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:ABRAHAM REST HOMEFACILITY NUMBER:
075601557
ADMINISTRATOR/
DIRECTOR:		ABRAHAM, SARAFACILITY TYPE:
740
ADDRESS:1035 BRIGHTWOOD COURTTELEPHONE:
(925) 286-3576
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY: 6CENSUS: 4DATE:
11/25/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Administrator Annette SanchezTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 11/25/2024 at 12:30 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a POC inspection. Upon entry, the LPA stated the purpose of the visit to Staff Member Mariela Cuaresma Medina. Administrator Annette Sanchez arrived at approximately 1:45 PM.

The LPA inspected the interior and exterior of the facility. During the inspection, the LPA measured the kitchen hot water temperature at 107.4 degrees Fahrenheit. The fire extinguisher was serviced on 11/21/2024. Those cleared the citations from 11/6/2024.

No citations issued during the inspection.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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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