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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601472
Report Date: 03/18/2021
Date Signed: 03/18/2021 03:29:16 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 (ALAMO II)FACILITY NUMBER:
075601472
ADMINISTRATOR:CHOU, SETEVE & GALLO, CFACILITY TYPE:
740
ADDRESS:10 CASTLE CREST ROADTELEPHONE:
(510) 685-8388
CITY:ALAMOSTATE: CAZIP CODE:
94507
CAPACITY:6CENSUS: 4DATE:
03/18/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Steve Chou, AdministratorTIME COMPLETED:
03:30 PM
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On 3/18/2021 at 2:45pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced Proof of Correction (POC) visit regarding a citation issued on 3/3/2021. LPA informed Steve Chou, Administrator, that due to Shelter in Place Order, this case management will be conducted via video conference. LPA met with Steve Chou, Administrator and explained the purpose of the visit.

POC was due on 3/10/2021. LPA confirmed with the state auditor that requested documents were not received. Failure to correct generates civil penalties being assessed from 3/11/2021- 3/18/2021 of $100 per day totaling $800.

Exit interview conducted. A copy of this report, appeal rights, and LIC421FC provided via email.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Laura HallTELEPHONE: (510) 622-2024
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2021
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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