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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200968
Report Date: 06/26/2025
Date Signed: 06/30/2025 02:08:46 PM

Document Has Been Signed on 06/30/2025 02:08 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:CONNECTED LIVING ANTIOCHFACILITY NUMBER:
079200968
ADMINISTRATOR/
DIRECTOR:		TRAIL, EDDIEFACILITY TYPE:
735
ADDRESS:2350 GALLOWAY COURTTELEPHONE:
(925) 826-6830
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY: 6CENSUS: 6DATE:
06/26/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Kay Trail, Administrator (ADM2)
Eddie Trail, Co-Administrator (ADM3)		TIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 06/26/25 at 1PM, LPA D Panlilio conducted an unannounced case management visit and met with administrators (ADM2, ADM3). LPA explained the purpose of the visit with ADMs. This is an amendment of the original case management visit conducted on 06/26/25.

On 03/23/25 at 4:30PM, LPA spoke with administrator (ADM1) on the phone and discussed the RCEB incident report received dated 03/20/25 (see 812 for more details).
Client (C1) was searched by government agents at the facility due to suspected child pornographic activities on his electronic devices (IPhone, Xbox game system, Computer). C1's electronic devices were confiscated by government agents at that time.

A conference meeting was held on 03/24/25 with C1's Regional Center of the East Bay (RCEB) case manager and staff (ADM2, ADM3). C1 was placed on 1:1 staff supervision 7X a week to monitor his internet and electronic usage.

Staff (ADM2, ADM3) continue to work with C1's RCEB case manager in addressing his health and safety needs.

Continued on next page, LIC 809-C
NAME OF LICENSING PROGRAM MANAGER: Bennett Fong
NAME OF LICENSING PROGRAM ANALYST: Daisy Panlilio
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: CONNECTED LIVING ANTIOCH
FACILITY NUMBER: 079200968
VISIT DATE: 06/26/2025
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At 4:30PM on 06/26/25, LPA secured original signed case management reports from ADMs and gave amended reports during visit.

Exit interview conducted and a copy of this report provided.
NAME OF LICENSING PROGRAM MANAGER: Bennett Fong
NAME OF LICENSING PROGRAM ANALYST: Daisy Panlilio
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC809 (FAS) - (06/04)
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