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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200630
Report Date: 07/16/2021
Date Signed: 07/16/2021 10:39:10 AM

Document Has Been Signed on 07/16/2021 10:39 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:BYRON PARKFACILITY NUMBER:
079200630
ADMINISTRATOR:MURRAY, JENNIFERFACILITY TYPE:
740
ADDRESS:1700 TICE VALLEY BLVDTELEPHONE:
(925) 937-1700
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY: 151CENSUS: 82DATE:
07/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Kathryn Geraghty, Wellness DirectorTIME COMPLETED:
10:50 AM
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On 7/16/2021 at 9:15AM, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct an Infection Control Inspection. LPA met with Wellness Director, Kathryn Geraghty and explained the purpose of the visit. Administrator, Jennifer Murray arrived later.

Upon entry, LPA observed the accushield monitor at the front desk. LPA's screening and temperature was completed through monitor, LPA observed employees using the accushield monitor. Hand sanitizer, and COVID-19 signage at entry and front desk. LPA toured facility including but not limited to common areas, bathrooms, and kitchen. All sinks were equipped with soap, and paper towel.

During record review, LPA observed facility has a copy of Mitigation Plan on file. LPA observed PPE is sufficient.

No deficiencies were cited during this inspection.

Exit interview conducted. A copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2021
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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