<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200228
Report Date: 07/10/2024
Date Signed: 07/10/2024 11:40:30 AM

Document Has Been Signed on 07/10/2024 11:40 AM - 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:HENRY AND HENRY ADULT DAY CAREFACILITY NUMBER:
019200228
ADMINISTRATOR/
DIRECTOR:		ALLEN HENRYFACILITY TYPE:
775
ADDRESS:3361 MACARTHUR BLVD.TELEPHONE:
(510) 530-9656
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY: 30CENSUS: 17DATE:
07/10/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Allen Henry, Administrator TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 07/10/2024 around 09:30 AM Licensing Program Analyst (LPA), L. Holmes arrived unannounced to conduct a 10-day complaint visit. A case management was conducted for a health and safety check as a result of CCLD receiving complaint #15-AS-20240709085701. LPA met with Allen Henry, Administrator (ADM).

Upon arrival, the majority if clients were engaged in multiple activities in the common area. LPA and ADM toured the facility including but not limited to the common areas, bathroom, kitchen, office, conference room and backyard. Hot water temperature in the shared bathroom measured at 113.7 degrees Fahrenheit (F.). There was a supply of snacks in the event that a client forgets their lunch. Medications are not kept at the facility. Personal belongings remain locked for safe keeping. Smoke and carbon monoxide units appeared operational during the visit. No accessible bodies of water were observed. Fire extinguisher last inspected 03/12/2024. Indoor and outdoor passageways were free of obstruction (2-3 ladders were stored in the backyard because a conference was taking place). C1 and C2 were in attendance at the facility.


Exit interview conducted and a copy of this report provided to Allen Henry, Administrator.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1