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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600335
Report Date: 07/11/2024
Date Signed: 07/11/2024 05:05:06 PM


Document Has Been Signed on 07/11/2024 05:05 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:REUTLINGER COMMUNITY, THEFACILITY NUMBER:
075600335
ADMINISTRATOR:MAMMAD, JULIEFACILITY TYPE:
741
ADDRESS:4000 CAMINO TASSAJARATELEPHONE:
(925) 648-2800
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY:120CENSUS: 69DATE:
07/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Skilled Nursing Administrator, Brian KallioTIME COMPLETED:
05:10 PM
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On 7/11/2024 at 12:30 PM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Skilled Nursing Administrator, Brian Kallio and explained the purpose of the visit. Executive Director was off at the time of visit. The facility’s fire clearance was approved for all may be non-ambulatory with 5 bedridden.

Smoke detectors are interconnected with sprinklers and observed throughout the facility. Fire and Disaster Drill was last conducted on 6/13/2024. Emergency Disaster Plan was last posted on 2/21/2024

LPA reviewed 7 residents records. LPA reviewed 5 staff records and 5 of 5 are associated to the facility.Training for staff providing ADLs is current and up to date. LPA reviewed a sample of resident’s medications.


The annual inspection is not complete. LPA will return to complete the inspection and tour the facility at a later date.



No deficiencies cited during visit. Exit interview conducted and a copy of this report provided
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) -28-0517
LICENSING EVALUATOR NAME: Alona GomezTELEPHONE: 510-239-1306
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
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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