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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015601398
Report Date: 11/15/2024
Date Signed: 11/15/2024 01:18:49 PM

Document Has Been Signed on 11/15/2024 01:18 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:QUAIL GARDEN 2FACILITY NUMBER:
015601398
ADMINISTRATOR/
DIRECTOR:		ALICIA PEACOCKFACILITY TYPE:
740
ADDRESS:836 SOUTH J STREETTELEPHONE:
(925) 872-2705
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
11/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Alicia Johnston, AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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On 11/15/2024 at 10:35AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Caregiver, Lilia Lazo and informed her the reason for the visit. Administrator, Alicia Johnston arrived 15 minutes later.

LPA toured the facility with Alicia including but not limited to bedrooms, bathrooms, dining area, kitchen, common areas, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguishers were observed to be full. There were adequate lights in each room. Hot water was measured at 115.3 degrees F in the hallway bathroom. Grab bars and non-skid mats were observed. One week supply of nonperishable and 2-day supply of perishable foods were available. Centrally stored medications were locked in the cabinet in the kitchen area. First Aid kit is complete. There was no bodies of water observed. Indoor and outdoor passages were free of obstruction. Last disaster drill was conducted on 10/15/2024.

LPA reviewed 4 residents and 4 staff files starting at 11:15AM. LPA reviewed a sample of resident's medications during visit. LPA interviewed 2 residents and 2 staff.

No deficiencies are being cited on this date.

Exit interview conducted. A copy of this report provided.
Harpreet HumpalTELEPHONE: (510) 285-3928
Grace LukTELEPHONE: (510) 286-4201
DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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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