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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201276
Report Date: 11/20/2024
Date Signed: 11/20/2024 10:48:00 AM

Document Has Been Signed on 11/20/2024 10:48 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:MCEWING HOMEFACILITY NUMBER:
079201276
ADMINISTRATOR/
DIRECTOR:
PITSCHNER, MARIANFACILITY TYPE:
735
ADDRESS:1200 MCEWING COURTTELEPHONE:
(925) 849-6086
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY: 6CENSUS: 1DATE:
11/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Administrator, Marian PitschnerTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 11/20/2024 at 9:15 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Marian Pitschner and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory downstairs only. Client was away at day program.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 1 bedrooms are occupied by the clients and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 72 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 105.9 degree Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygienes were available for clients. There is a minimum of one week supply of non-perishables and 2-day perishables food supply. Freeze temperature:0 Refrigerator Temperature:35

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 01/03/2024. First aid kit was observed to be complete. Fire drill was last conducted on 11/03/2024. Emergency plan reviewed 11/20/2024

At 9:30 am, 1 of 1 clients records were reviewed. At 9:50 am, 2 staff records were reviewed and 2 of 2 have current first aid training and associated to the facility. A sample of 1 client’s medications were reviewed.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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