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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201363
Report Date: 08/08/2024
Date Signed: 08/08/2024 03:08:29 PM

Document Has Been Signed on 08/08/2024 03:08 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:ADAURE HOME CAREFACILITY NUMBER:
079201363
ADMINISTRATOR/
DIRECTOR:		ESOMONU, JUSTINEFACILITY TYPE:
735
ADDRESS:1073 METTEN AVETELEPHONE:
(925) 214-8468
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY: 6CENSUS: 4DATE:
08/08/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Justine Esomonu, AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:10 PM
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On 8/8/2024 at 12:30pm, Licensing Program Analyst (LPA) L. Hall arrived announced to conduct Pre-licensing inspection/change of ownership. LPA met with Justine Esomonu, Administrator, and explained the purpose of the visit. The facility has a fire clearance for six (6) non-ambulatory. There were not any clients present during inspection.

LPA inspected the facility inside and out including but not limited to the bedrooms, bathrooms, common living areas, kitchen, garage and back yard. The facility has a total of four (4) bedrooms and two (2) bathrooms. One bedroom occupied by staff. There is sufficient lighting around the facility. Clients rooms are equipped with the beds, chairs, and lighting. Clients' rooms have proper bedding and linens. Passageways and hallways are free of obstruction. No bodies of water observed. Hot water temperature is measured at 115.2 degrees Fahrenheit. Fire extinguisher was last serviced on 8/28/2023. Fire drill last conducted 6/2/2024. Smoke detectors/carbon Monoxide detector are equipped around the facility. First aid kit is complete.

Licensing Program Manager Y. Lairos-Flores gave approval to waive COMP III.

No Issues were noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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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