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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200309
Report Date: 04/02/2024
Date Signed: 04/02/2024 08:58:34 AM

Document Has Been Signed on 04/02/2024 08:58 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:GLENN VIEWFACILITY NUMBER:
019200309
ADMINISTRATOR:KRISTABELLE ALATASFACILITY TYPE:
735
ADDRESS:38524 GLENVIEW DRIVETELEPHONE:
(510) 894-1971
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 3CENSUS: 0DATE:
04/02/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Occupent, Jonathen ValentinoTIME COMPLETED:
09:05 AM
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On 04/02/2024 at 7:30 AM, Licensing Program Analysts (LPAs) A. Gomez and A. Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Occupant, Jonathen Valentino and explained the purpose of the visit. The occupant is a caregiver at the licensee's other facility. LPAs spoke with licensee, Yolonda Alatas over the phone. The licensee stated that there are no residents for over 2 years and that they want to change the facility license to RCFE. The facility’s fire clearance was approved for 3 non-ambulatory.

LPAs toured facility with Occupant including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of potential residents. The hot water temperature was measured at 111.1 degrees Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition.

Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 2/20/2024.

LPAs informed Licensee to notify CCLD if they start taking clients so that another inspection can be conducted. LPAs also advised administrator to contact CCLD if they would like to start the process of converting their license to RCFE from ARF.

There are no staff or client files for review.


No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/02/2024
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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