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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201006
Report Date: 11/20/2020
Date Signed: 11/20/2020 12:55:34 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:VIAMONTE AT WALNUT CREEKFACILITY NUMBER:
079201006
ADMINISTRATOR:MITCHELL, MELODYFACILITY TYPE:
741
ADDRESS:2801 SHADELANDS DRIVETELEPHONE:
(925) 621-6600
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:300CENSUS: 0DATE:
11/20/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Melody MitchellTIME COMPLETED:
12:00 PM
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On 11/20/2020 at 10:00AM, Licensing Program Analyst (LPA) Roland Pitcher conducted a Tele-visit Pre-Licensing inspection via face time due to shelter in place directed by the Governor. LPA spoke with Executive Director, Melody Mitchell for this purpose. Contra Costa Fire Department approved the fire clearance to occupy 280 Non-Ambulatory and 20 Bedridden residents upon licensure.

During the Tele-Inspection, LPA virtually toured the building inside and outside, but not limited to inspecting apartments on the 1st, 2nd and 3rd. There is independent, assisted living and memory care units, bathroom, three dining areas, commercial kitchen, two laundry rooms, art studio, media room, library, conference room, fitness area, secured pool, spa, outdoor courtyards and medication room to secure centrally stored medications, first aid kit as well as 2 exam rooms.

Bathrooms are equipped with grab bars and non skid shower flooring. The hot water temperature was measured in resident bathroom sink, which is within the required range of 105 to 120 degrees. Auditory device signals were in place to monitor exits and delayed egress doors are operational in the Memory Care unit. Toxic substances such as cleaning supplies will be locked secured in housekeeping. LPA observed sufficient lighting throughout the building. A 7-day supply of non-perishable foods and non-perishable food will be purchased prior to resident move-in.

Smoke detectors are interconnected with sprinkler system and carbon monoxide detectors are in common areas and apartments.

Report continued on LIC809C
SUPERVISOR'S NAME: Julio MontesTELEPHONE: (510) 286-0518
LICENSING EVALUATOR NAME: Rolanda PitcherTELEPHONE: (510) 542-0253
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2020
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: VIAMONTE AT WALNUT CREEK
FACILITY NUMBER: 079201006
VISIT DATE: 11/20/2020
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The Component III was waived due to Administrator, Melody Mitchell demonstrated sufficient knowledge and understanding on how to operate a facility in compliance within Community Care Licensing Title 22, Division Regulation.

This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed, and is subject to final approval by Centralized Application Unit.

Exit interview was completed with Melody Mitchell

SUPERVISOR'S NAME: Julio MontesTELEPHONE: (510) 286-0518
LICENSING EVALUATOR NAME: Rolanda PitcherTELEPHONE: (510) 542-0253
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2020
LIC809 (FAS) - (06/04)
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