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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201455
Report Date: 03/06/2025
Date Signed: 03/06/2025 01:14:19 PM

Document Has Been Signed on 03/06/2025 01:14 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:DISCOVERY COMMONS SAN RAMONFACILITY NUMBER:
079201455
ADMINISTRATOR/
DIRECTOR:		STROMGREN, KIELFACILITY TYPE:
740
ADDRESS:12720 ALCOSTA BLVDTELEPHONE:
(925) 725-1485
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY: 95CENSUS: 77DATE:
03/06/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Executive Director, Kiel StromgrenTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 03/06/2025 at 9:00 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced/announced to conduct a pre-licensing inspection. LPA met with Executive Director, Kiel Stromgren and explained the purpose of the visit. The facility currently has no residents.

LPA toured facility with Executive Director including but not limited to bedrooms, bathrooms, kitchen, common areas and courtyards. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 72 degrees F and hot water temperature was observed at 115.3, 110.4, and degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 12/20/2024. No bodies of water observed.

Comp III Conducted/Completed

No issues noted during inspection. LPAs 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: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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