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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200444
Report Date: 02/21/2025
Date Signed: 02/21/2025 03:33:04 PM

Document Has Been Signed on 02/21/2025 03:33 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:WAY OF THE ELDERSFACILITY NUMBER:
019200444
ADMINISTRATOR/
DIRECTOR:		SISTER MARYGRACE PUCHACFACILITY TYPE:
775
ADDRESS:2700-A MERCED STREETTELEPHONE:
(510) 352-1867
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 40CENSUS: 0DATE:
02/21/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Sister Mary GraceTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On this day at around 10:45 am, LPA Luisa Fontanilla arrived unannounced to this location to verify the Elders Way Day Program.

LPA observed construction workers on site and a new signage installed.

At around 10:50 am, LPA drove to 797 Montague Avenue, San Leandro, the temporary relocation site of the clients. This location is the site for Evergreen Program, another ADP operated by the Licensee and licensed by CCL. LPA spoke with Sister Mary Grace and obtained the following information:
  • ADP lost the lease from the previous location on December 31, 2024
  • the new location is located at 14826 Wicks Blvd, San Leandro 94577
  • the city required sprinklers for the new location and are currently being installed
  • might take 2 months before the new location gets completed
  • application for the new license will be submitted to CAB by Monday, 2/24/2025
  • CCL was not informed when clients were moved to the Montague location due to time constraint


LPA explained to Sister Mary Grace that currently Way of the Elders is unlicensed and that the participants are in a program that is not licensed by CCL. LPA explained that for the Way of the Elders clients to be under a licensed program, she can have them sign a temporary admission agreement under the Evergreen Program until the new location gets licensed. LPA advised Sister Mary Grace that once the new location has passed the city requirements, CCL still needs to conduct a pre-licensing inspection.
continuation on Lic 809C
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Luisa Fontanilla
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: WAY OF THE ELDERS
FACILITY NUMBER: 019200444
VISIT DATE: 02/21/2025
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LPA advised Sister Mary Grace to reach out to CCL if she needs assistance with the application process.

A copy of this report was provided to Brian Jimenez, Team Lead who is authorized by Sister Mary Grace to sign the report.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Luisa Fontanilla
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC809 (FAS) - (06/04)
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