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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015601468
Report Date: 12/10/2024
Date Signed: 12/10/2024 02:04:53 PM

Document Has Been Signed on 12/10/2024 02:04 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:DIMOND CARE IIFACILITY NUMBER:
015601468
ADMINISTRATOR/
DIRECTOR:
BLAIN, JOHN F.FACILITY TYPE:
740
ADDRESS:3015 FRUITVALE AVENUETELEPHONE:
(510) 599-2191
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
12/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Helen Blain AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 12/10/2024 at 9:30 AM, Licensing Program Analyst (LPA) D. Doidge and Licensing Program Manager (LPM) J. Fong arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPA stated the purpose of the visit to Helen Blain, Administrator.

The LPA and LPM inspected the facility inside and outside. All outdoor and indoor passageways were free of obstruction. Outside, there were no bodies of water. Inside, the temperature was measured at 74 degrees Fahrenheit. The LPA and LPM observed adequate lighting in all of the rooms for the comfort and safety of the residents. The hot water temperature in a common bathroom was measured at 104.4 degrees Fahrenheit. Food is brought over from kitchen housed in adjacent facility. Food supplies in kitchen were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications and cleaning supplies were observed locked. Sharps were stored inaccessible to residents. Smoke and carbon monoxide detectors were in operating condition. Fire extinguisher was observed to be fully charged and last serviced on 05/28/2023. Last Fire Drill conducted 10/01/2024.

The LPA reviewed the records of four (4) residents and five (5) staff members all were complete.

Facility does not handle resident cash resources

At 11:00 Am LPA, observed screens in Bedroom 3, full bathroom and in front room in need of repair.

At 1:00 PM, LPA observed Complaint Poster (PUB 475) is not 20” x 26” in size.

No citations issued.

Exit interview conducted with Licensee. A copy of this report provided to the Licensee.
Bennett FongTELEPHONE: (510) 286-4201
David DoidgeTELEPHONE: (916) 475-5913
DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
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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