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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201124
Report Date: 04/13/2023
Date Signed: 04/13/2023 05:52:30 PM


Document Has Been Signed on 04/13/2023 05:52 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:LOVING TOUCH CARE HOMESFACILITY NUMBER:
079201124
ADMINISTRATOR:BROOME, MERCEDESFACILITY TYPE:
740
ADDRESS:285 EBANO DRTELEPHONE:
(925) 393-5779
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:6CENSUS: 4DATE:
04/13/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee Mynette BoykinTIME COMPLETED:
06:00 PM
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On 04/12/2023 at 1:00 PM, Licensing Program Analyst (LPA) J Sampair arrived unannounced for a Plan of Correction (POC) visit. LPA explained purpose of the visit to staff member Hilda Manuel who informed Licensee Mynette Boykin by phone. Licensee arrived at facility at 2:30 PM.

Licensee cleared all POCs from 04/05/2023 visit.

No citations issued during POC inspection.

Exit interview conducted with Licensee. Copy of this report provided via email.

SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2023
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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