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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200861
Report Date: 03/29/2023
Date Signed: 03/29/2023 02:26:37 PM

Document Has Been Signed on 03/29/2023 02:26 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:GAENOR HOME INCFACILITY NUMBER:
079200861
ADMINISTRATOR:NORIEGA, DIONEILFACILITY TYPE:
735
ADDRESS:1754 SATTLER DRTELEPHONE:
(925) 332-7907
CITY:CONCORDSTATE: CAZIP CODE:
94519
CAPACITY: 6CENSUS: 6DATE:
03/29/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Dioneil NoriegaTIME COMPLETED:
02:39 PM
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On 03/29/2023 at 1:15 PM Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to conduct a Case Management. LPA met with Dioneil Noriega.

LPA came to discuses with the Licensee about the current administrative certificate. LPA explained to Dioneil that all adult residential facilities shall have a certified administrator. Dioneil stated that the facility has submitted an application along with 40 hours of Additional Continuing Education Units (ACEU) to the Administrator Certification Section (ACS), and was contacted back saying that he needed to submit an additional 44 hours to bring certificate to current to 2023.

Dioneil then stated that he has already completed 12 of the additional 44 hours, and is planning on completing the rest of the hours this week/weekend and will be submitting them to ACS once completed.

LPA stated that Dioneil will continue to stay in communication with the AGPA from ACS and ask for conformation that it was all received and submitted.

Exit interview conducted.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2023
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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