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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200879
Report Date: 12/27/2024
Date Signed: 12/27/2024 12:15:22 PM

Document Has Been Signed on 12/27/2024 12:15 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:MERRILL GARDENS AT ROCKRIDGEFACILITY NUMBER:
019200879
ADMINISTRATOR/
DIRECTOR:		GOO, AUBREYFACILITY TYPE:
740
ADDRESS:5238 CORONADO AVETELEPHONE:
(510) 338-4543
CITY:OAKLANDSTATE: CAZIP CODE:
94618
CAPACITY: 150TOTAL ENROLLED CHILDREN: 0CENSUS: 127DATE:
12/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Interim General Manager Aubrey GooTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On 12/27/2024 at 09:00 AM, Licensing Program Analysts (LPA) D. Doidge arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with, Interim General Manager Aubrey Goo and explained the purpose of the visit.

LPA toured the facility including but not limit to, bedrooms, bathrooms, multiple activity rooms, kitchen, and common area. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 72 degrees Fahrenheit. The hot water temperature in a common bathroom was measured at 119 degrees Fahrenheit. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps are locked and inaccessible to residents in care.

Fire extinguisher was last serviced on 11/16/2024. Emergency disaster drill are conducted monthly, last conducted on 11/20/2024.

LPA reviewed five (5) resident records and five (5) staff records, all were complete.

No deficiencies observed or cited during this visit. .

Exit interview conducted and a copy of this report provided
Bennett FongTELEPHONE: (510) 286-4201
David DoidgeTELEPHONE: (916) 475-5913
DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2024
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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