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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019201162
Report Date: 02/21/2025
Date Signed: 02/21/2025 11:43:08 AM

Document Has Been Signed on 02/21/2025 11:43 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:DEBBIE'S CARE HOMEFACILITY NUMBER:
019201162
ADMINISTRATOR/
DIRECTOR:		PICKENS, DEBRAFACILITY TYPE:
735
ADDRESS:6008 MARTIN LUTHER KING JR WAYTELEPHONE:
(510) 812-2127
CITY:OAKLANDSTATE: CAZIP CODE:
94609
CAPACITY: 4CENSUS: 4DATE:
02/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Administrator Debra PickensTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 02/21/202509:50 AM, at Licensing Program Analyst (LPA) D. Doidge arrived unannounced to conduct 1-Year Annual Required inspection. LPA Met with Administrator, Debra Pickens and explained the purpose of the visit.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 70 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in residents shared bathroom was measured at 115.7 degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for clients. There is a minimum of one-week supply of non-perishables and 2-day perishables food supply.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 02/18/2025. First aid kit was observed to be complete. Fire and emergency drills are conducted monthly, last on 02/10/2025.

LPA reviewed four (4) clients’ records and four (4) staff records and all were complete.

No deficiencies were cited during this inspection. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
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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