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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200801
Report Date: 10/08/2024
Date Signed: 10/08/2024 02:35:03 PM

Document Has Been Signed on 10/08/2024 02:35 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:WESTMONT OF PINOLEFACILITY NUMBER:
079200801
ADMINISTRATOR/
DIRECTOR:		REMIGIO, RICHARDFACILITY TYPE:
740
ADDRESS:2850 ESTATES AVETELEPHONE:
(510) 758-1122
CITY:PINOLESTATE: CAZIP CODE:
94564
CAPACITY: 100CENSUS: 73DATE:
10/08/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Richard Remigio, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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On 10/8/24 at 01:40 PM, Licensing Program Analysts (LPAs) Carol Fowler and David Doidge arrived unannounced to conduct a case management. LPAs met with Richard Remigio, Executive Director, and explained the purpose of the visit.

On 10/02/24, LPA received an LIC624A regrading the resident 1 hit by a car. LPAs reviewed R1’s files, interviewed Richard Remigio, Executive Director, Resident 1 and Staff 2 LPAs requested and received LIC602 Physician’s Report/Medical Assessment, and after visit summary.

Interview with R1 and staff revealed that R1 was crossing Pinole Valley Road in the crosswalk with a green light and a car hit him. After being hit the driver of the car and people in the area helped him until the Police, Staff (from the facility) and ambulance arrived. R1 is able to leave the facility unassisted.

No deficiencies were cited today.



Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2024
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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