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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200882
Report Date: 05/12/2021
Date Signed: 05/12/2021 05:41:36 PM

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:CHERISH CARE HOME INC.FACILITY NUMBER:
079200882
ADMINISTRATOR:OKEIGWE, OGEDIFACILITY TYPE:
740
ADDRESS:15 DICKSON LANETELEPHONE:
(925) 250-3044
CITY:MARTINEZSTATE: CAZIP CODE:
94553
CAPACITY:6CENSUS: 3DATE:
05/12/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Administrator Ogedi OkeigweTIME COMPLETED:
05:30 PM
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Licensing Program Analyst (LPA) Delmundo conducted a health and safety inspection as a result of the Department receiving a complaint (Control # 15-AS-20210511161656). LPA informed Ogedi Okeigwe, administrator, that due to Shelter in Place Order by the Governor and management directive to telework, inspection will be done via video conference.

LPA requested Ogedi Okeigwe to tour LPA to the facility starting from the front door. LPA requested to open the front door and exit doors which LPA observed with auditory signals. LPA inspected the living room, kitchen, dining area, bedrooms, bathrooms, side and backyard. There's 1 staff on-duty and 2 residents present during inspection.

Food supplies were checked and observed sufficient. Facility has sufficient lighting. Hallways and passageways were observed free of obstructions. Medications were kept in a closet with lock. Knives were observed in a locked box inside the cabinet in the kitchen.

Copy of this report provided to Ogedi Okeigwe via e-mail.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 622-2621
LICENSING EVALUATOR NAME: Alicia DelmundoTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021
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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