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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200131
Report Date: 09/27/2024
Date Signed: 09/27/2024 04:44:29 PM

Document Has Been Signed on 09/27/2024 04:44 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:PATHWAY, THEFACILITY NUMBER:
079200131
ADMINISTRATOR/
DIRECTOR:		CARSWELL, JOHNFACILITY TYPE:
772
ADDRESS:550 PATTERSON BLVD.TELEPHONE:
(925) 938-8050
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 16CENSUS: 14DATE:
09/27/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:John Carswell, Campus AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 09/27/2024 at 3:00 PM, Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Health and Safety as a result of a priority 2 complaint. LPA explained the purpose of the visit with Campus Director, John Carswell.

Upon entry into the facility, LPA observed that there were no receptionist at the front desk to greet. LPA waited at the front desk while two (2) staff members walked by and then LPA was greeted by a staff coming from out from their office. LPA toured facility with staff (S1), including but not limited to kitchen, shower rooms, laundry rooms, linen closets, Corner Store, and common areas. LPA observed four (4) residents sitting outside and fourteen (14) residents sitting in a common area playing bingo. Residents in care appear to be safe and there are no imminent health and safety concerns on today's date.

No deficiencies cited during the Health and Safety check. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2024
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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