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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200218
Report Date: 08/13/2024
Date Signed: 08/13/2024 02:42:43 PM

Document Has Been Signed on 08/13/2024 02:42 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:MISSION-HOPE DAY PROGRAM, DUBLINFACILITY NUMBER:
019200218
ADMINISTRATOR/
DIRECTOR:		JAY FRANCIS Y. GAMEZFACILITY TYPE:
775
ADDRESS:6300 VILLAGE PARKWAYTELEPHONE:
(925) 560-9582
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 45CENSUS: 72DATE:
08/13/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:49 PM
MET WITH:Grace Valdez, Case Manager TIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On 8/13/2024 at 12:50 PM., Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with case manager Grace Valdez and program director Maribeth Wilson and explained the purpose of the visit. Day program operates from 7:30 a.m. to 3:30 p.m. Monday to Friday. There were 19 staff observed working at the program today.

LPA toured the facility including but not limited to: activity rooms, kitchen, bathrooms, office space, and the outside recreational area. Clients bring their own lunches and snacks and water are provided by the program. Emergency supplies, including water were observed. The hot water temperature in the kitchen measured at 108.5 degrees Fahrenheit. Cleaning supplies are locked and inaccessible to clients. Restrooms are maintained in safe and in sanitary operating condition, and additional equipment for the physically handicapped was observed. The program has 6 vans used for client outings and transportation. LPA observed 4 that were on the premises were observed to be clean.

Clients have a variety of activities and are provided activity materials. Kitchen and food preparation area were observed as clean.

LPA reviewed 6 client and 5 staff files; all were complete. Emergency disaster drills are conducted on a monthly basis. Fire extinguishers throughout facility were last inspected 02/23/2024. First aid kit was checked and observed to be complete.

No deficiencies were cited during this inspection. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2024
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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