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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600353
Report Date: 05/01/2024
Date Signed: 05/01/2024 05:31:24 PM


Document Has Been Signed on 05/01/2024 05:31 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:ATRIA VALLEY VIEWFACILITY NUMBER:
075600353
ADMINISTRATOR:BINDRA, MONIQUE SFACILITY TYPE:
740
ADDRESS:1228 ROSSMOOR PKWYTELEPHONE:
(925) 937-7300
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY:153CENSUS: 106DATE:
05/01/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Executive Director Monique BindraTIME COMPLETED:
05:45 PM
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On 5/1/2024 at 12:30 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPA stated the purpose of the visit to Executive Director (ED) Monique Bindra.

The LPA inspected the physical plant with the ED which included the kitchen, dining room, restrooms, community living spaces, resident rooms, storage, and the exterior of the facility. In the kitchen, more than the required minimum of 7 days of nonperishable and 2 days of perishable foods were appropriately stored. examined the emergency food and water supplies. Fire extinguishers were last serviced on 1/3/2024 and the most recent inspection of the fire suppression systems were completed on 1/3/2024 and 1/23/2024 and the fire alarm on 2/22/2024.

The LPA verified the completion of required staff training and the completion of quarterly emergency/disaster training for staff during every shift. The LPA observed postings in the facility that included a complaint poster, Ombudsman and Personal Rights posters, Theft and Loss Policy, Rights to Resident Council, and Rights to Family Council. An administrator is on site more than the minimum of 20 hours a week to oversee the proper business operations.

The LPA reviewed 5 resident and 5 staff files and interviewed 5 staff and 5 residents.

No citations issued during the inspection.

Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 529-9416
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/01/2024
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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