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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601180
Report Date: 10/23/2020
Date Signed: 10/23/2020 03:54:21 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:WELCOME HOME SENIOR RESIDENCE (WALNUT CREEK)FACILITY NUMBER:
075601180
ADMINISTRATOR:CHOU, STEVEFACILITY TYPE:
740
ADDRESS:2421 WASDEN COURTTELEPHONE:
(925) 944-0204
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:6CENSUS: 2DATE:
10/23/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Steve Chou, AdministratorTIME COMPLETED:
02:40 PM
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An Informal Meeting was conducted today to gather more information concerning the bankruptcy filing. The meeting was conduted via televisit using FaceTime due to the present shelter in place order by the Governor. Present in the meeting today, representing the business entity, Administrator Steve Chou. Yvonne Flores-Larios, Licensing Program Manager (LPM), and Laura Hall, Licensing Program Analyst (LPA).

During the meeting, those present discussed the present facility operations, reporting requirements, and future plans for the facilities. The facility is licensed as an Residential Care Facility for the Elderly.

During this meeting the following facilities were included in the discussion:
· 075601570 Welcome Home Senior Residence Concord
· 079200513 Welcome Home Senior Residence Concord II
· 075601389 Welcome Home Senior Residence Alamo
· 075601472 Welcome Home Senior Residence Alamo II
· 075601180 Welcome Home Senior Residence Walnut Creek
· 015601211 Welcome Home Senior Residence
· 015601411 Welcome Home Senior Residence Pleasanton

LPM requested the following documents for each facility by 10/24/2020.
  • Bankruptcy filing.
  • LIC500

Exit interview conducted and a copy of this report was emailed.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Laura HallTELEPHONE: (510) 622-2024
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2020
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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