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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600335
Report Date: 09/15/2023
Date Signed: 09/15/2023 04:14:52 PM


Document Has Been Signed on 09/15/2023 04:14 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:REUTLINGER COMMUNITY, THEFACILITY NUMBER:
075600335
ADMINISTRATOR:MAMMAD, JULIEFACILITY TYPE:
741
ADDRESS:4000 CAMINO TASSAJARATELEPHONE:
(925) 648-2800
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY:120CENSUS: 77DATE:
09/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Julie Mammad, Executive Director TIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) K. Nguyen and Associate Governmental Program Analyst (AGPA) L. Francisco arrived unannounced to conduct a 1-Year Annual Required visit on this date starting at 10:15am. LPA and AGPA met with Executive Director (ED), Julie Mammad, and Social Services Director (SSD), Caroline Allen.

LPA toured facility with SSD including but not limited to random resident's bedrooms, bathrooms, kitchen, common area, and outdoor area. There are no bodies of water observed. Indoor and outdoor passageways are kept free of obstruction. Room temperature in the hallway is maintained at 74 degrees F. Hot water temperature in random residents’ bathroom is maintained at 110, 111, 115, and 106 degrees F. Random resident's bathrooms were equipped with grab bars and non-skid mats. Hygiene supplies were available for residents. Centrally stored medications are inaccessible to residents. There is a minimum of one week supply of non-perishable and 2-day perishable foods. Refrigerator temperature was maintained at 38 degrees F and freezer temperature was maintained below 4 degrees F.

Smoke detectors are interconnected with sprinklers and observed throughout the facility. Fire extinguisher was last serviced on 12/02/2022. Fire and Earthquake Drill was last conducted on 6/25/2023. Emergency Disaster Plan was last posted on 11/20/2022.

LPA reviewed 5 staff records. 5 of 5 staff are associated and have current first-aid training. Training for staff providing ADLs is current and up to date. LPA reviewed 5 resident records and 5 of 5 residents have current Medical Assessment on file. LPA reviewed a sample of resident's medications.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Kelly NguyenTELEPHONE: (510) 915-8702
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2023
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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