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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201402
Report Date: 02/11/2025
Date Signed: 02/11/2025 12:21:15 PM

Document Has Been Signed on 02/11/2025 12:21 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:IN GREAT HANDSFACILITY NUMBER:
079201402
ADMINISTRATOR/
DIRECTOR:		GOSS,MUWANDE;ANTHONY,DOMINFACILITY TYPE:
735
ADDRESS:917 MULBERRY WAYTELEPHONE:
(510) 847-8819
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 6CENSUS: 0DATE:
02/11/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:05 AM
MET WITH:Muwande Goss, Dominick Anthony, AdministratorsTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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On 02/11/2025 at 10:05AM, Licensing Program Analyst (LPA) L. Hall conducted an announced pre-licensing inspection. LPA met with Muwande Goss, Dominick Anthony, Administrators. The facility has an approved fire safety clearance for six (6) 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 a total of five (5) bedrooms and two and one half (2 1/2) bathrooms. One bedroom will be occupied by staff. No bodies of water observed. There is sufficient lighting around the facility. Residents rooms are equipped with the proper furniture, bedding, and lighting. Passageways and hallways are free of obstruction.Hot water temperature is measured at 144.9 degrees Fahrenheit in shared residents' bathroom. There is a minimum of 7-day non-perishables and 2-day perishables foods. First Aid kit was complete. Carbon monoxide and smoke detectors present.

LPA observed the following shall be corrected by 2/18/2025.
  • Locked cabinet or closet for medication, sharps and toxins.
  • Updated facility sketch.
  • Water between 105 and 120 degrees F.


Continued on LIC809C.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: IN GREAT HANDS
FACILITY NUMBER: 079201402
VISIT DATE: 02/11/2025
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Continued from LIC809.

Issues were noted during inspection. LPA observed that facility is not 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: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC809 (FAS) - (06/04)
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