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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200977
Report Date: 10/29/2024
Date Signed: 10/29/2024 03:27:04 PM

Document Has Been Signed on 10/29/2024 03:27 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:WE CARE ELDERLY CAREFACILITY NUMBER:
079200977
ADMINISTRATOR/
DIRECTOR:		WHITE, BRITTANY DFACILITY TYPE:
740
ADDRESS:4155 BELL AVETELEPHONE:
(510) 375-4460
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY: 8CENSUS: 5DATE:
10/29/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH: Lurinza Bean, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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On 10/29/24 around 09:00 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct an initial 10-day complaint visit and Health and Safety Check. Upon arrival, LPA met with Lurinza Bean, Licensee (S1) and spoke with Brittany White, Administrator (ADM) by phone and explained the reason for the visit to both.

Upon arrival LPA observed one (1) Care Staff monitoring the facility and attending to the residents that were in there room. LPA and S1 toured the facility including, but not limited to bathrooms, kitchen, common areas, laundry area, dining area, garage, staff room, and backyard. The facility consists of 4 (four) bedrooms. All outdoor and indoor passageways are free of obstruction. There were no bodies of water. A comfortable temperature was maintained however the residents preferred 63 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 113.9 degrees (F). All toilets, hand washing, and bathing areas were safe, sanitary and in operating condition with paper towels, and soap observed at all hand washing stations. Linen and hygiene products available for all residents. PPE, sanitizer, and paper goods remained sufficient. Fire extinguisher last inspected 03/03/24 and smoke/carbon monoxide detectors were operational.

Exit interview conducted and a copy of this report provided Licensee.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
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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