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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200396
Report Date: 08/09/2024
Date Signed: 08/09/2024 01:21:04 PM

Document Has Been Signed on 08/09/2024 01:21 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:HAND IN HAND FOR PROGRESS DAY PROGRAMFACILITY NUMBER:
079200396
ADMINISTRATOR/
DIRECTOR:		JIAN FRANCO GAMEZFACILITY TYPE:
775
ADDRESS:2025 PT. CHICAGO HWY.TELEPHONE:
(925) 332-7973
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY: 30CENSUS: 30DATE:
08/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Case Manager, Kathleen Womack TIME VISIT/
INSPECTION COMPLETED:
01:25 PM
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On 08/09/2024 at 11:15 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct the Required 1 Year Annual inspection. LPA met with Case Manager, Kathleen Womack and explained the purpose of the visit. Day program operates from 7:30 AM - 3:30 PM.

LPA toured facility with Kathleen including but not limited to multiple activity rooms, kitchen, bathrooms, office spaces, and the garden/patio area. LPA observed sufficient furniture and lighting throughout the facility. Clients bring their own lunches and snacks, snacks are also provided by facility. Emergency supplies, including water were observed. Cleaning supplies and medications are locked and inaccessible to clients. Medications are dispensed by the Program Coordinator as needed. There are no bodies of water. Comfortable temperature was maintained at 79 degrees Fahrenheit inside the facility. Restrooms were observed clean and sanitary. The hot water temperature in the client bathroom measured 119.2 degrees Fahrenheit. Incontinent clients are kept clean and dry, and the facility is free of odors.

The program has 3 vans used for client outings that are clean, insured, and up to date on registration. Fire extinguishers throughout facility were last inspected 4/01/2024. Smoke detectors and carbon monoxide were in operating condition during visit. LPA observed smoke detectors are interconnected with sprinkler system. First aid kit was complete. Emergency Disaster plan last updated 8/18/2023. Fire Drill last done 6/3/2024

At 11:45 AM LPA reviewed 5 clients records. At 12:20 AM, LPA reviewed 5 staff records and 5 of 5 have first aid training and are associated to the facility


No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2024
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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