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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601028
Report Date: 02/28/2025
Date Signed: 02/28/2025 11:01:53 AM

Document Has Been Signed on 02/28/2025 11:01 AM - 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:BELROSE CARE HOME IIFACILITY NUMBER:
075601028
ADMINISTRATOR/
DIRECTOR:		JUNSAY, ROSA C.FACILITY TYPE:
740
ADDRESS:36 BAI GORRY PLACETELEPHONE:
(925) 932-8822
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
02/28/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Licensee / Administrator Rosa JunsayTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On February 28, 2025 at 08:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this annual required inspection. The LPA informed Caregivers Liwayway Noche and Arnel Bulaon of the purpose for this visit. Licensee / Administrator Rosa Junsay arrived at approximately 10:00 AM.

The LPA inspected the inside and outside of the facility. The inspection included the kitchen, dining area, living room, bedrooms, bathrooms, garage, and yard. An adequate amount of food supplies were observed, more than the required minimum of 2 days of perishable and 7 days of non-perishable food. The central storage for medications was locked. The cleaning supplies and dangerous objects were stored in locked cabinets.

Facility has working smoke and carbon monoxide detectors. Facility conducts disaster/emergency and fire drills on a quarterly basis; records showed that the most recent drill was conducted on December 20, 2024. The fire extinguisher was fully charged and last serviced on January 9, 2025. The indoor temperature was 71.0 degrees Fahrenheit and the maximum hot water temperature was 113.5 degrees Fahrenheit, both within the acceptable range.

The LPA reviewed 5 resident and 5 staff records.

No citations were issued during this inspection.

Exit interview conducted and a copy of this report provided.
Harpreet HumpalTELEPHONE: (510) 529-9416
James SampairTELEPHONE: (510) 286-4201
DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2025
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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