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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200288
Report Date: 02/15/2023
Date Signed: 02/16/2023 11:08:32 AM


Document Has Been Signed on 02/16/2023 11:08 AM - 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:DIPINA BOARD AND CAREFACILITY NUMBER:
079200288
ADMINISTRATOR:PATEL, SALINAFACILITY TYPE:
740
ADDRESS:63 SAINT RAMON COURTTELEPHONE:
(925) 314-0841
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY:6CENSUS: 0DATE:
02/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:10 PM
MET WITH:Not availableTIME COMPLETED:
04:30 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 2/15/2023 starting at 4:10 PM, Licensing Program Analyst (LPA) L. Francisco and K. Nguyen arrived unannounced to conduct a Case Management visit to confirm closure of facility.

During the case management, LPAs rang the Ring camera door bell and spoke to the owner through the Ring camera. Homeowner informed LPAs that they purchased the home over a year ago and is now a private home. LPA checked on Redfin.com and observed property was sold on 11/4/2021.

On 11/12/2021, LPA L. Francisco spoke to Licensee and LPA was informed that the property was sold on 11/4/2021.

On 2/15/23, LPA contacted Licensee/Administrator and left a voicemail. Licensee/Administrator was not available to sign.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Lizette FranciscoTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023
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