<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601411
Report Date: 01/07/2025
Date Signed: 01/07/2025 12:29:22 PM

Document Has Been Signed on 01/07/2025 12:29 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:MUIR CREEK SENIOR HOMEFACILITY NUMBER:
075601411
ADMINISTRATOR/
DIRECTOR:		CARBONEL, LELIA C.FACILITY TYPE:
740
ADDRESS:1066 MUIR CREEK DRIVETELEPHONE:
(925) 427-7049
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/07/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Lelia Carbonel, AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 1/7/2025 at 11:30am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Administrator, Lelia Carbonel, and explained the purpose of the visit. There are not any residents residing in the facility.

LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three (3) bathrooms. Staff occupies one (1) bedroom. All outdoor and indoor passageways are kept free of obstruction. LPA did not observe any bodies of water. A comfortable temperature is maintained at 68 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 119.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 01/02/2025 First aid kit was observed to be complete.

One (1) staff records were reviewed and all were complete.

Exit interview conducted and a copy of this report provided.
Harpreet HumpalTELEPHONE: (510) 285-3928
Laura HallTELEPHONE: (510) 622-2024
DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1