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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200050
Report Date: 07/23/2024
Date Signed: 07/23/2024 04:33:20 PM

Document Has Been Signed on 07/23/2024 04:33 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:WESTWOOD RESIDENTIAL CAREFACILITY NUMBER:
079200050
ADMINISTRATOR/
DIRECTOR:		REBECCA HERNANDEZFACILITY TYPE:
735
ADDRESS:2228 WESTWOOD COURTTELEPHONE:
(925) 709-1595
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY: 6CENSUS: 5DATE:
07/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:05 PM
MET WITH:Arminda Manalang, CaregiverTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On 7/23/2024 at 3:05pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced annual required inspection. LPA met with Arminda Manalang, Caregiver, and explained the purpose of the visit. Administrator, Rebecca Hernandez, arrived at 3:30pm. Administrator holds a certificate #6025714735 expires 3/13/20225. Facility has a fire clearance for six (6) ambulatory clients.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area, garage, and back yard. The facility consists of five (5) bedrooms and two (2 ) bathrooms. One (1) bedroom occupied by staff. All indoor and outdoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 147.0 degrees Fahrenheit. All toilets, hand washing, and bathing are sanitary and in operating condition. Non skid mats are in bath tubs. Hand washing poster, paper towel, and soap observed at all hand washing stations. The supply of extra hygiene was available for residents. There is a minimum of 7-day non-perishables and 2-day perishables foods.

Smoke detectors/carbon monoxide were in operating condition during visit. Emergency disaster plan updated 8/1/2023. Fire extinguisher was last services on 5/11/2023. Fire drill last conducted 5/30/2024. First aid kit was observed to be complete.

Continued on LIC809C.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: WESTWOOD RESIDENTIAL CARE
FACILITY NUMBER: 079200050
VISIT DATE: 07/23/2024
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Continued from LIC809.

Four (4) staff records were reviewed, current and complete. All five (5) clients' records reviewed, current, and complete.

The following forms to be updated and submitted to CCLD by 7/20/2024:
  • LIC500 (Personnel Record)
  • LIC308 (Designation of facility Responsibility)
  • LIC 400 Affidavit Regarding Client/Resident Cash Resources
  • Surety Bond


No deficiencies cited during visit.

Exit interview and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC809 (FAS) - (06/04)
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