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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200189
Report Date: 03/16/2022
Date Signed: 03/16/2022 12:18:57 PM

Document Has Been Signed on 03/16/2022 12:18 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:CARE ADMINISTRATION AND MGMT. PROFESSIONALS, INC.FACILITY NUMBER:
019200189
ADMINISTRATOR:ELIZABETH DELATORREFACILITY TYPE:
775
ADDRESS:6805 SIERRA COURT, SUITE ATELEPHONE:
(925) 560-0124
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 54CENSUS: DATE:
03/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Elizabeth De La Torre TIME COMPLETED:
12:25 PM
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On 03/16/22 at 11: 25 am Licensing Program Analysts (LPAs) J. Clancy-Czuleger and K. Nguyen arrived unannounced to conduct infection control inspection LPAs meet with Administrator Elizabeth De La Torre and explained the purpose of the visit.

During the Infection Control Inspection, LPAs toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen, and back area. Facility has a sufficient one week non-perishable food supply. There is one central entry point for universal screening for staff, and visitors. Clients are screened when they are picked up. Hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. The facility has a mitigation plan. Closet for cleaning supplies, and central storage for medications were observed with locks. Fire extinguishers were observed fully charge and tags showed serviced October 2021.


No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2022
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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