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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015601404
Report Date: 04/08/2022
Date Signed: 04/08/2022 01:45:20 PM


Document Has Been Signed on 04/08/2022 01:45 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:FAIRVIEW CARE HOMEFACILITY NUMBER:
015601404
ADMINISTRATOR:FRONE, AURICAFACILITY TYPE:
740
ADDRESS:24933 SECOND STREETTELEPHONE:
(510) 690-0080
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY:6CENSUS: 0DATE:
04/08/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Aurica Frone/Licensee-Administrator TIME COMPLETED:
01:45 PM
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On November 12, 2021, Aurica Frone, licensee-administrator, sent a notification indicating her intent to close the facility, and that she has given notification to the facility’s last two (2) residents. On January 22, 2022, licensee sent another notification that the residents have moved-out.

On this day, April 8, 2022, Licensing Program Analyst (LPA) Delmundo arrived to the facility to conduct case management inspection and met with Aurica Frone. LPA toured the facility and observed no sign of residents living in the facility. LPA informed licensee that LPA will proceed with the closure process.

Exit interview conducted and copy of this report provided.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 622-2621
LICENSING EVALUATOR NAME: Alicia DelmundoTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 04/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2022
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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