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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200305
Report Date: 02/26/2025
Date Signed: 02/26/2025 05:08:43 PM

Document Has Been Signed on 02/26/2025 05:08 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:REDWOOD HOME AT NILES GROVEFACILITY NUMBER:
019200305
ADMINISTRATOR/
DIRECTOR:		EDITH SARMIENTOFACILITY TYPE:
735
ADDRESS:35537 NILES BLVDTELEPHONE:
(510) 818-0720
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 6CENSUS: 6DATE:
02/26/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:00 PM
MET WITH:Edith Sarmiento, Administrator TIME VISIT/
INSPECTION COMPLETED:
05:25 PM
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On 2/26/2025 at 4:00 PM, Licensing Program Analyst (LPA) K. Nguyen conducted a Health & Safety inspection as a result of a priority 1 complaint. LPA met with Administrator (ADM), Edith Sarmiento and explained the purpose of the visit.

Administrator certificate expires on 07/07/2025. The facility’s fire clearance was approved for all six (6) non-ambulatory and one (1) may be bedridden.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six total bedrooms which all bedrooms are occupied by the clients and one office for the Administrator. There are no bodies of water. A comfortable temperature for clients is maintained at 69 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 105 degree Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygiene's and linen was available for clients. Cabinet for knives, cleaning supplies, and centrally storage for medication were observed locked. Outdoor activity space was observed furnished with tables, chairs and shade.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 06/6/2024. Fire Drill conducted 1/25/2025. First aid kit was observed to be complete.


No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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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