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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601363
Report Date: 03/07/2025
Date Signed: 03/07/2025 12:26:09 PM

Document Has Been Signed on 03/07/2025 12:26 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:MEMORY CARE OF CONTRA COSTAFACILITY NUMBER:
075601363
ADMINISTRATOR/
DIRECTOR:		DIALA, ERICAFACILITY TYPE:
740
ADDRESS:540 PATTERSON BOULEVARDTELEPHONE:
(925) 287-8750
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 75CENSUS: 55DATE:
03/07/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Erica Diala, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 03/07/2025 at 11:30 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct a Plan of Correction (POC) visit. LPA met with Laura-Anne Leake-Mosley, Executive Assistant, and explained the purpose of the visit. Executive Director, Erica Diala, was not available but arrived around 11:35am.

On 01/29/2025, LPA conducted an Annual Inspection visit in which deficiencies were cited. The POC due date was 02/26/2025. Administrator failed to submit the POC by the due date and this is why LPA came to make a POC visit.
Deficiencies not cleared:

87411(c)(1) $100 X 9 days = $900.00

During visit Laura gave copies of First Aid/CPR certificates for staff (S) S1 and S2. Deficiency cleared on 03/07/2025.

Civil Penalties in the total amount of $900.00 is assessed today for failure to meet POC date for deficiencies.

Exit interview conducted. A copy of this report, appeal rights provided and LIC421FC provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2025
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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