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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600352
Report Date: 06/21/2023
Date Signed: 06/21/2023 11:03:47 AM


Document Has Been Signed on 06/21/2023 11:03 AM - 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:ATRIA WALNUT CREEKFACILITY NUMBER:
075600352
ADMINISTRATOR:KELLI GREENEFACILITY TYPE:
740
ADDRESS:1400 MONTEGOTELEPHONE:
(925) 938-6611
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:200CENSUS: 118DATE:
06/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Life Guidance Director Antoine RabbatTIME COMPLETED:
11:30 AM
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On 06/21/2023 at 9:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a Required - 1 Year Inspection. Upon entry, LPA stated the purpose of the visit with Life Guidance Director (LGD) Antoine Rabbat. LPA began tour of facility.

At 9:50 AM, LPA spoke with Executive Director (ED) Kelli Greene over the phone about her not being able to be at the facility during the inspection. Due to the size of the facility and recent administrative changes, the LPA chose to stop the inspection and return at a later date to complete his inspection of the facility.

No citations issued during this inspection.

Exit interview conducted with LGD Antoine Rabbat. A copy of this report provided via email.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2023
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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