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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201309
Report Date: 12/15/2023
Date Signed: 12/15/2023 01:32:09 PM


Document Has Been Signed on 12/15/2023 01:32 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:ABEMU RESIDENCE CAREFACILITY NUMBER:
079201309
ADMINISTRATOR:JOY MANALANG-ENRIQUEZFACILITY TYPE:
740
ADDRESS:3101 BOWLING GREEN DRIVETELEPHONE:
(650) 278-1899
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:6CENSUS: 5DATE:
12/15/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Applicant Joy Manalang-EnriquezTIME COMPLETED:
02:00 PM
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On 12/15/2023 at 9:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a prelicensing inspection of the facility with Applicant Joy Manalang-Enriquez. Upon arrival, the LPA identified himself and verified the purpose of the meeting.

The LPA and Applicant completed the prelicensing inspection of the facility inside and outside.

COMP III training completed with Administrator at 11:40 AM.

There are no deficiencies. Pre-Licensing is complete.

Exit interview conducted and a copy of this report was provided via email to Applicant Joy Manalang-Enriquez.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) -62-2621
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2023
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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