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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201386
Report Date: 09/12/2024
Date Signed: 09/12/2024 01:42:04 PM

Document Has Been Signed on 09/12/2024 01:42 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:CORAL HOME CARE LLCFACILITY NUMBER:
079201386
ADMINISTRATOR/
DIRECTOR:		REYES, LOUISFACILITY TYPE:
740
ADDRESS:180 CORAL BELL WAYTELEPHONE:
(925) 306-9304
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY: 6CENSUS: 0DATE:
09/12/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:16 AM
MET WITH:Louis Reyes, AdministraorTIME VISIT/
INSPECTION COMPLETED:
01:53 PM
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On 09/12/2024 at 11:12AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an announced pre-licensing inspection. LPA met with Ivette Reyes, Licensee and Louis Reyes, Administrator, and explained the purpose of the visit. The facility has an approved fire safety clearance for six (6) non ambulatory residents. LPA inspected the facility inside and out including but not limited to the bedrooms, bathrooms, common living areas, kitchen, garage, back yard. The facility has four (4) bedrooms and three (3) bathrooms. There is sufficient lighting around the facility. LPA observed two (2) out of the four (4) residents’ bedrooms are equipped with hospital beds with bed rails, two (2) were equipped with proper beds and bedding, all rooms have proper lighting. LPA observed Bathrooms showers/tubs were equipped with grab bars and non-skid mats. LPA observed a television in the common living room area.

LPA observed locked cabinets to store medications and sharps. Hot water temperature is measured at 119.8 degrees Fahrenheit in shared residents' bathroom. A comfortable temperature was observed at 73 degrees. Fire extinguisher was last purchased on 04/26/2024. Personnel files were not completed and available during visit. LPA did not review any files during visit.

The following items must be corrected prior to licensing:
  • Each room must be furnished with proper beds (no bed rails) and bedding.
  • Signal System for each resident's room.
  • Completed Personnel Files for Administrator/Licensee
  • Gate on the side of the property is damaged needs repair and removal of the extra gates leaning against the property.
  • Bedroom closet must be clear and not used for storage.
  • 7 days of non-perishables and 2 days of perishables.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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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