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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201218
Report Date: 08/01/2024
Date Signed: 08/01/2024 04:49:49 PM


Document Has Been Signed on 08/01/2024 04:49 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612



FACILITY NAME:BYRON PARKFACILITY NUMBER:
079201218
ADMINISTRATOR:RICARDO ROMEROFACILITY TYPE:
740
ADDRESS:1700 TICE VALLEY BLVDTELEPHONE:
(925) 937-1700
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY:151CENSUS: 172DATE:
08/01/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Executive Director Ricardo RomeroTIME COMPLETED:
05:00 PM
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On 8/1/2024 at 2:00 PM, Licensing Program Analysts (LPAs) James Sampair and David Doidge arrived unannounced for a case management visit concerning the 7/25/2024 incident with Resident R1 who reported their debit card missing. Upon entering the facility, the LPAs stated the purpose of visit to Executive Director (ED) Ricardo Romero.

During the visit, the LPAs interviewed the ED and R1 about the incident. The ED stated that an internal investigation was initiated and that both Walnut Creek and Concord Police Departments were pursuing the investigation and that a former staff member, S1, whose employment had been terminated for a different reason on 7/29/2024, was the main suspect. Resident R1 confirmed that she was being treated with respect and support by the facility staff and that they were working to protect her and other residents from theft.

No citations issued during this visit.

Exit interview was conducted with the ED. A copy of this report was provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 529-9416
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024
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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