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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200127
Report Date: 01/16/2025
Date Signed: 01/16/2025 12:03:45 PM

Document Has Been Signed on 01/16/2025 12:03 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:LAMORINDA ADULT RESPITE CENTERFACILITY NUMBER:
079200127
ADMINISTRATOR/
DIRECTOR:		KATHLEEN JANUSZEWAKIFACILITY TYPE:
775
ADDRESS:433 MORAGA WAYTELEPHONE:
(925) 254-3465
CITY:ORINDASTATE: CAZIP CODE:
94563
CAPACITY: 35CENSUS: 8DATE:
01/16/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Program Director Kathleen JanuszewskiTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 01/16/2025 at 10:00 AM, Licensing Program Analyst (LPA) David Doidge arrived to conduct 1-Year Annual Required inspection. LPA met with Kathleen Januszewski, Program Director and explained the purpose of the visit. Day program operates from 11:00 AM to 3:00 PM. Monday to Thursday. There were 4 staff observed working at the program today.

LPA toured facility including but not limited to: activity rooms, kitchen, bathrooms, office space, and the outside recreational area. Clients bring their own lunches and snacks are provided by the program. Emergency supplies, including water were observed. The hot water temperature in the hallway bathroom measured 114.6 degrees Fahrenheit. Cleaning supplies are locked and inaccessible to clients. Medications are not handled/dispensed by this program. There are no bodies of water or fire safety hazards observed. Restrooms are maintained in safe and in sanitary operating condition. Incontinent clients are kept clean and dry, and the facility is free of odors.

LPA reviewed five (5) client and four (4) staff files and all were complete. Emergency disaster drills are conducted every six months. Fire extinguishers throughout facility were operational last serviced 04/11/2024. First aid kit was checked and observed to be complete.

No deficiencies were cited during this inspection.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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