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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200326
Report Date: 01/27/2025
Date Signed: 01/27/2025 04:04:30 PM

Document Has Been Signed on 01/27/2025 04:04 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:ATRIA PARK OF LAFAYETTEFACILITY NUMBER:
079200326
ADMINISTRATOR/
DIRECTOR:		ANTHONY, KAWANAFACILITY TYPE:
740
ADDRESS:1545 PLEASANT HILL RDTELEPHONE:
(925) 932-9910
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY: 130TOTAL ENROLLED CHILDREN: 0CENSUS: 83DATE:
01/27/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Beverly Mercurio/Resident Services Director TIME VISIT/
INSPECTION COMPLETED:
04:05 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 this day, January 27, 2025, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a health and safety inspection as a result of the Department receiving a priority 1 complaint (Complaint #15-AS-20250123123225). LPA met with Resident Services Director (RSD) Beverly Mercurio, and informed the reason for visit.

LPA toured the facility inside out with the RSD. The facility is a 3 level building. LPA inspected the common areas, game room on the 1st floor, dining room, kitchen, multi purpose room, grand view room and theatre on the 3rd floor. The electrical room on the 2nd floor and salon on the 3rd floor were observed locked. LPA randomly selected 8 apartments for inspection - 3 on the 1st floor, 3 on the 2nd floor and 2 on the 3rd floor.

No deficiency observed.

Exit interview conducted and copy of this report provided to RSD.
Bennett FongTELEPHONE: (510) 622-2621
Alicia DelmundoTELEPHONE: (510) 286-4201
DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2025
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