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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015600811
Report Date: 01/15/2025
Date Signed: 01/15/2025 03:05:32 PM

Document Has Been Signed on 01/15/2025 03:05 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:KENNEDY GUEST HOMEFACILITY NUMBER:
015600811
ADMINISTRATOR/
DIRECTOR:		JOYCELYN SILLAFACILITY TYPE:
740
ADDRESS:2636 KENNEDY STREETTELEPHONE:
(925) 449-0145
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
01/15/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Joycelyn Castro Silla, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On 1/15/2025 at 10:00AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Joycelyn Castro Silla and explained the purpose of the visit.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 12/4/2024. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 105.7 degrees F in the kitchen sink. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete. Last disaster drill was conducted on 1/6/2025. Indoor and outdoor passageways were free of obstructions. No bodies of water was observed.

LPA reviewed 3 residents and 3 staff files starting at 11:00AM. LPA reviewed the three resident's medications starting at 1:40PM. LPA interviewed 2 staff during inspection.

No deficiencies are being cited on this date.

Exit interview conducted. A copy of this report provided.
Harpreet HumpalTELEPHONE: (510) 285-3928
Grace LukTELEPHONE: (510) 286-4201
DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/15/2025
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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