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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600335
Report Date: 11/18/2022
Date Signed: 11/18/2022 02:52:32 PM


Document Has Been Signed on 11/18/2022 02:52 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
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612



FACILITY NAME:REUTLINGER COMMUNITY, THEFACILITY NUMBER:
075600335
ADMINISTRATOR:LAUB, BENJAMINFACILITY TYPE:
741
ADDRESS:4000 CAMINO TASSAJARATELEPHONE:
(925) 648-2800
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY:120CENSUS: 64DATE:
11/18/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Julie Mammad, Executive DirectorTIME COMPLETED:
03:05 PM
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On 11/9/22 at 1:50PM, Licensing Program Analyst (LPA) C. Lin conducted an unannounced case management visit as a result of receiving residents from Grand Lake Gardens (GLG) and check on residents. LPA met with Executive Director and explained the purpose of the visit.

During visit, LPA obtained Reutlinger (REUT) assisting living staff schedules. A total of 3 residents from GLG are currently living in REUT. LPA attempted to visit 1 resident who moved in to assisting living last week but resident was sleeping.

Adequate food, paper, PPE supplies were observed, staffing is stable.

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

Exit interview conducted with Executive Director and copy of this report provided.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 622-2621
LICENSING EVALUATOR NAME: Catherine LinTELEPHONE: 510-622-2053
LICENSING EVALUATOR SIGNATURE:
DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/18/2022
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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