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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201484
Report Date: 02/13/2025
Date Signed: 02/13/2025 06:14:24 PM

Document Has Been Signed on 02/13/2025 06:14 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:INSPIRED ASSISTED LIVING WALNUT CREEKFACILITY NUMBER:
079201484
ADMINISTRATOR/
DIRECTOR:
WEIL, JORDANFACILITY TYPE:
740
ADDRESS:15 GLEN CREEK LANETELEPHONE:
(925) 200-2509
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY: 6CENSUS: 6DATE:
02/13/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Administrators Lisa Weil and Jordan WeilTIME VISIT/
INSPECTION COMPLETED:
06:30 PM
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On 2/13/2025, at 11:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct the Pre-Licensing inspection. Upon entry, the LPA informed Administrators Lisa Weil and Jordan Weil of the purpose of the visit.

The LPA inspected the inside and outside of the facility with the administrators. The inspection included the kitchen, dining area, living room, bedrooms, bathrooms, garage, and the exterior of the facility. An adequate amount of food supplies was observed, more than the required minimum of 2 days of perishable and 7 days of non-perishable food. The central storage for medications was in a locked cabinet. Sharp objects, poisons, and cleaning supplies were all in locked storage.

The facility has fully functioning smoke and carbon monoxide detectors. The staff of the facility conduct disaster/emergency and fire drills more frequently than the required quarterly basis; records showed that the most recent drill was conducted on 1/17/2024. The fire extinguisher was fully charged and last serviced on 9/26/2024. The indoor temperature in the dining room at 3:10 PM was 71.6 degrees Fahrenheit and the maximum hot water temperature was 110.6 degrees Fahrenheit, both within the acceptable temperature range.

The LPA reviewed 5 resident and 5 staff records.

Pre-Licensing is complete and this facility has no deficiencies.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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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