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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201037
Report Date: 05/21/2024
Date Signed: 05/21/2024 03:40:43 PM


Document Has Been Signed on 05/21/2024 03:40 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:GREEN PASTURES RESIDENCES LLC - OAKMONT MANORFACILITY NUMBER:
079201037
ADMINISTRATOR:ENRIQUEZ, STEPHANIE NARESFACILITY TYPE:
740
ADDRESS:1408 OAKMONT PLTELEPHONE:
(925) 858-1870
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:6CENSUS: 1DATE:
05/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Herminia P. Clarito, CaregiverTIME COMPLETED:
03:50 PM
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On 05/21/2024 at 3:00pm, Licensing Program Analyst (LPA), L. Hall conducted an unannounced case management inspection regarding a denied fire clearance. LPA met with Herminia P. Clarito and spoke with Licensee, Stephanie Enriquez, via telephone and LPA explained the reason for the visit.

Upon arrival LPA observed only one (1) client present. S1 stated that she emailed LPA on 5/12/2024, but LPA did not receive email. S1 stated email indicated that a contractor had been notified to conduct required work. R1 would be moved to a different room during construction. S1 stated work will possibly start next week and take a couple of days. At this time nothing is definite. LPA inquired on an Administrator, being the present Administrator will no longer be employed in June. S1 stated she will find a replacement Administrator.

No deficiencies cited during visit.

Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Laura HallTELEPHONE: (510) 622-2024
LICENSING EVALUATOR SIGNATURE:
DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2024
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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