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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601424
Report Date: 01/14/2025
Date Signed: 01/14/2025 12:02:16 PM

Document Has Been Signed on 01/14/2025 12:02 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:AEGIS ASSISTED LIVING OF MORAGAFACILITY NUMBER:
075601424
ADMINISTRATOR/
DIRECTOR:		MARIA ANGELES STICKAFACILITY TYPE:
740
ADDRESS:950 COUNTRY CLUB DRIVETELEPHONE:
(925) 377-7900
CITY:MORAGASTATE: CAZIP CODE:
94556
CAPACITY: 100TOTAL ENROLLED CHILDREN: 0CENSUS: 59DATE:
01/14/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Angeles Sticka General ManagerTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 01/14/2025 at 08:15 AM, Licensing Program Analysst (LPAs) David Doidge and James Sampair arrived unannounced to conduct an annual required inspection. LPAs met with General Manager Angeles Sticka and explained the purpose of the visit.

LPA toured the facility including but not limit to, bedrooms, bathrooms, multiple activity rooms, kitchen, and common area. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 72 degrees Fahrenheit. The hot water temperature in a common bathroom was measured at 120 degrees Fahrenheit. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps are locked and inaccessible to residents in care.

Fire extinguisher was last serviced on 12/18/2024. Emergency disaster drill are conducted monthly, last conducted on 12/20/2024.

LPA reviewed five (5) resident records and five (5) staff records, all were complete.

No deficiencies observed or cited during this visit. .

Exit interview conducted and a copy of this report provided
Bennett FongTELEPHONE: (510) 286-4201
David DoidgeTELEPHONE: (916) 475-5913
DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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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