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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201127
Report Date: 01/10/2022
Date Signed: 01/10/2022 03:05:51 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:ABEMU RESIDENCE CAREFACILITY NUMBER:
079201127
ADMINISTRATOR:ENRIQUEZ, JOY MANALANGFACILITY TYPE:
740
ADDRESS:2978 MIRANDA AVETELEPHONE:
(408) 449-8044
CITY:ALAMOSTATE: CAZIP CODE:
94507
CAPACITY:6CENSUS: 5DATE:
01/10/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Joy Enriquez, Licensee/AdministratorTIME COMPLETED:
03:20 PM
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On 1/10/2022 starting at 2:35 PM, Licensing Program Analyst (LPA) L. Francisco conducted a face to face Component III presentation. LPA met with Licensee/Administrator, Joy Enriquez.

LPA presented Component III power point and discussed the regulations embodied in the power point. LPA observed participant gained knowledge about running and maintaining the facility in accordance with regulations.

Exit interview conducted with Licensee/Administrator and a copy of report provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Lizette FranciscoTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022
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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