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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201239
Report Date: 02/24/2023
Date Signed: 02/24/2023 11:27:59 AM


Document Has Been Signed on 02/24/2023 11:27 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612



FACILITY NAME:VIRA CARE AT ASPENFACILITY NUMBER:
079201239
ADMINISTRATOR:VAHID, ELVIRAFACILITY TYPE:
740
ADDRESS:1111 ASPEN DRIVETELEPHONE:
(925) 948-5221
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY:6CENSUS: 0DATE:
02/24/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Elvira Vahid, AdministratorTIME COMPLETED:
11:15 AM
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On 2/24/2023 at 9:30 AM, Licensing Program Analyst (LPA) P. Watson arrived announced to conduct Pre-Licensing inspection. LPA met with Administrator, Elvira Vahid and explained the purpose of the visit. The facility currently has no residents/clients.

LPA toured facility with Elvira including but not limited to 5 bedrooms, 2 bathrooms, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a drawers. There is sufficient lighting throughout facility. Room temperature was maintained at 69 degrees F. Hot water was unable to be checked due to issues with the water heater. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 1/4/2023.


Prior to licensure, the following shall be corrected and faxed to CCL by 2/28/2023

- Water heater would need to be fixed and hot water would need to be checked, hot water needs to be within 105 degrees F. and 120 degrees F.

Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) 725-7926
LICENSING EVALUATOR NAME: Paris WatsonTELEPHONE: (510) 622-2625
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2023
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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