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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201416
Report Date: 01/03/2025
Date Signed: 01/03/2025 02:40:34 PM

Document Has Been Signed on 01/03/2025 02:40 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:STRAWBERRY HILL AT GILL PORTFACILITY NUMBER:
079201416
ADMINISTRATOR/
DIRECTOR:		ASILUM, MARY KAROLINEFACILITY TYPE:
740
ADDRESS:2069 GILL PORT LNTELEPHONE:
(925) 448-2977
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY: 6CENSUS: 4DATE:
01/03/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:30 AM
MET WITH:Mary AsilumTIME 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 1/03/2025 at 7:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a change of ownership prelicensing visit. Upon entry into the facility, the LPA informed Applicant Mary Asilum of the purpose of the visit.

The LPA toured the facility inside and outside. The LPA inspected the kitchen, common areas, bedrooms, bathrooms, and the exterior of the facility. The facility was clean, appropriately furnished, and well lit. More than the 2 days of perishable and 7 days of nonperishable food supplies were available. No body of water was on the facility grounds. Medications are centrally stored. Bathrooms and showers were observed to be fully functioning and clean. Carbon monoxide and smoke detectors were operational. The fire extinguisher was last serviced on 05/03/2024. Inside temperature was 73.2 degrees Fahrenheit.

Facility did not pass this prelicensing inspection. The LPA will return unannounced after the POCs have been completed with the existing Licensee.

Exit interview conducted and a copy of this report provided to the Applicant.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2025
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