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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200082
Report Date: 04/17/2024
Date Signed: 04/17/2024 02:15:46 PM

Document Has Been Signed on 04/17/2024 02:15 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:ROYAL COLONY IN BERKELEYFACILITY NUMBER:
019200082
ADMINISTRATOR/
DIRECTOR:		ALEGRE, FELIX JAMESFACILITY TYPE:
735
ADDRESS:1606 ALCATRAZ AVE.TELEPHONE:
(510) 655-8221
CITY:BERKELEYSTATE: CAZIP CODE:
94703
CAPACITY: 32CENSUS: 25DATE:
04/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Fexlix James Alegre, AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 4/17/2024 at 9:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Fexlix James Alegre and explained the purpose of the visit. The facility’s fire clearance was approved for 28 ambulatory and 4 non-ambulatory clients.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, common area, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguishers were observed to be full and last serviced on 5/9/2023. One week of nonperishable and 2-day of perishable food supplies were available. Facility purchase food every other week. Facility has emergency food available. There were adequate lights in each room. First Aid kit is complete. No bodies of water observed. Indoor and outdoor passageways were free of obstruction. Last fire drill was conducted on 3/10/2024.

LPA reviewed 5 clients and 3 staff files starting at 10:45AM. LPA reviewed a sample of client's medications starting at 1:30PM. LPA interviewed 3 clients and 3 staff starting at 1:00PM.

No deficiencies are being cited on this date.

Exit interview conducted. A copy of this report was provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2024
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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