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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200626
Report Date: 01/04/2023
Date Signed: 01/04/2023 10:32:55 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 01/04/2023 10:32 AM - 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:LIMERIDGE SENIOR LIVINGFACILITY NUMBER:
079200626
ADMINISTRATOR:FIEL, JAMES AFACILITY TYPE:
740
ADDRESS:1100 FAIR WEATHER CIRCLETELEPHONE:
(925) 798-8239
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY: 3CENSUS: 0DATE:
01/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:James and Rose FielTIME COMPLETED:
10:40 AM
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On 1/4/2023 at 8:50 am LPA J. Clancy-Czuleger conducted an unannounced required annual inspection, meeting with Licensee James and Rose Fiel and explained the purpose of the visit. The Licensee informed the LPA that they have not ever had any residents at the facility but are looking into getting some later this year.

The home is clean and organized. Inside temperature was comfortable and facility has a central climate control system. Each resident room has lighting, a bed, night stand and storage space. Exterior doors are alarmed. There is a locked space where medications will be securely centrally stored. All outdoor and indoor passageways are free and clear of obstruction. Common area lighting is operational. Items dangerous to dementia residents are already secured. There are several common areas with furnishings in good repair and enough to provide comfort and enjoyment for the residents and visitors.

Pesticides and poisons are not being stored in food areas or kitchen; as there are no residents yet in place, food for residents was not observed. However, the personal food of the Licensees was observed to be fresh and properly stored. The kitchen, including the food storage cabinets and refrigerators are clean.

Grab bars are available for each toilet, bathtub, and shower used by residents; bathtubs and showers have non-skid surfaces and/or mats; there is an adequate supply of hygiene items and clean linens available.

There are no client files to review. Licensee will inform LPA when they do get residents.

No Deficiencies Cited. Report was reviewed and a copy provided to Licensees.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE: DATE: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/04/2023
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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