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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600632
Report Date: 10/31/2023
Date Signed: 10/31/2023 04:59:17 PM


Document Has Been Signed on 10/31/2023 04:59 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:TENDER TOUCH RESIDENTIAL CARE HOMEFACILITY NUMBER:
075600632
ADMINISTRATOR:CRUZ, ESTRELLITA S.FACILITY TYPE:
740
ADDRESS:58 MIDHILL ROADTELEPHONE:
(925) 228-5683
CITY:MARTINEZSTATE: CAZIP CODE:
94553
CAPACITY:6CENSUS: 5DATE:
10/31/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Elyxandro Esteban, CaregiverTIME COMPLETED:
04:30 PM
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On 10/31/2023, at 3:30 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct Proof of Correction (POC) inspection visit to verify that the POCs had been implemented in a manner consistent with POC dated on 10/20/2023. Upon entry into the facility, the LPA identified herself and the purpose of the LPA met with Caregivers Elyxandro Esteban and Dianne Castelo and explained the purpose of the visit. Elyxandro phoned Licensee/Administrator, Estrellita Cruz and informed.

LPA L. Alexander toured the facility to verify that POCs were changed with the daybed removed from the garage. LPA observed that the daybed was removed. Deficiency cleared during visit.



No citations were issued during this visit. A copy of this report was provided via email.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Lori Alexander-WashingtonTELEPHONE: (510) 285-3934
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2023
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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