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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201386
Report Date: 09/19/2024
Date Signed: 09/19/2024 12:29:56 PM

Document Has Been Signed on 09/19/2024 12:29 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:
09/19/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Licensee, Ivette Reyes and Administrator, Louis ReyesTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 09/19/2024 at 10:45AM, Licensing Program Analyst (LPA) T.Syess-Gibson arrived to conduct final pre licensing inspection and met with Licensee Ivette Reyes, and Administrator Louis Reyes.

LPA checked the following corrected items from previous visit on 09/12/2024. LPA observed all rooms were fully equipped with complete bedding, signal systems in the rooms, 7 days of non-perishables and 2 days of perishables , cleaned closet in bedroom and Gate on the side of the property repaired and extra gates were removed.

LPA conducted COMP III presentation with Licensee and Administrator during today's visit.


After today's visit, the Pre- Licensing inspection has been completed. 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.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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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