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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201458
Report Date: 03/07/2025
Date Signed: 03/07/2025 05:43:26 PM

Document Has Been Signed on 03/07/2025 05:43 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
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:EDEN SENIOR CAREFACILITY NUMBER:
079201458
ADMINISTRATOR/
DIRECTOR:		MUNGAI, RAHABFACILITY TYPE:
740
ADDRESS:10 SHEILA CTTELEPHONE:
(925) 891-4435
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 6CENSUS: 5DATE:
03/07/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Rahab Mungai, Licensee/AdministratorTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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On 03/07/2025 at 3:00 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct Prelicensing inspection. LPA met with Caregiver, Elizabeth Ulloa and explained the purpose of the visit. Elizabeth phoned Licensee/Administrator, Rahab Mungai, to inform. Rahab arrived approx. shortly after. The facility currently has five (5) residents. The facility has an approved fire safety clearance for six (6) non-ambulatory in which one (1) resident may be bedridden.

LPA toured the facility including but not limited to five (5) bedrooms, three (3) bathrooms, kitchen, common areas and backyard. 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 74 degrees F and hot water temperatures was measured at 119.1 and 114.9 degrees F in two (2) residents' shared bathrooms. There is a minimum of 7-day non-perishables and 2-day perishables foods. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 03/03/2025.

LPA presented Component III power point and discussed the regulations embodied in the power point. LPA observed participant gained knowledge about running and maintaining the facility in accordance with regulations.

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

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2025
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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