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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200873
Report Date: 05/11/2023
Date Signed: 05/11/2023 03:36:51 PM


Document Has Been Signed on 05/11/2023 03:36 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:POINT AT ROCKRIDGE, THEFACILITY NUMBER:
019200873
ADMINISTRATOR:KNOX, KATHLEEN LFACILITY TYPE:
740
ADDRESS:4500 GILBERT STREETTELEPHONE:
(510) 658-9266
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY:186CENSUS: 136DATE:
05/11/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Stephanie Brice, AdministratorTIME COMPLETED:
03:45 PM
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On 5/11/23 at 1:40 p.m., Licensing Program Analyst (LPA) Greg Clark conducted an unannounced case management visit as a result of this facility receiving residents from Vista Terrace of Belmont (VTB). LPA met with Stephanie Brice, Administrator and explained the purpose of the visit.

The facility initially received 11 VTB residents on 4/28/23. On 4/29/23 one VTB resident arrived at the facility after a hospital stay. On 4/30/23 one resident was sent out to the hospital per her request and will not be returning. Another VTB resident was 5150'd on 5/01/23 and will not be returning. Current census of VTB residents at the facility is 10.

During the visit, LPA toured the facility including but not limited to the 10 apartments where the residents from VTB reside. All apartments were fully furnished with a bed, chair, night stand, lamp and personal belongings. LPA observed an adequate supply of hygiene items in the resident's bathrooms. During the tour LPA spoke to all 10 residents. All residents expressed that they had all of the supplies they need at this time..

Food, staffing and hygiene supplies were all observed to be adequate during visit.

There was no imminent health/safety concerns on today's date.

Exit interview conducted and copy of this report provided.
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory ClarkTELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2023
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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