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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075601557
Report Date: 11/25/2024
Date Signed: 11/25/2024 04:07:10 PM

Document Has Been Signed on 11/25/2024 04:07 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:ABRAHAM REST HOMEFACILITY NUMBER:
075601557
ADMINISTRATOR/
DIRECTOR:
ABRAHAM, SARAFACILITY TYPE:
740
ADDRESS:1035 BRIGHTWOOD COURTTELEPHONE:
(925) 286-3576
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
11/25/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Administrator Annette SanchezTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 11/25/2024 at 12:30 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a Case Management - Annual Continuation inspection to complete the Required Annual Inspection that was partially completed on 11/06/2024. Upon entry, The LPA stated the purpose of the visit to Staff Member Mariela Cuaresma Medina. Administrator Annette Sanchez arrived at approximately 1:45 PM.

The LPA inspected the interior and exterior of the facility. The inspection of the physical plant included the kitchen, dining area, restrooms, community living spaces, resident rooms, storage areas, garage, and the grounds of the facility. More than the required minimum of 7 days of nonperishable and 2 days of perishable foods were appropriately stored. At approximately 2:25 PM, the kitchen hot water temperature was 107.4 and the living room temperature was 72.5 degrees Fahrenheit. The fire extinguisher was last serviced on 11/21/2024.

The carbon monoxide and smoke detectors were fully operational. The LPA observed required postings in the facility, including the Residential Care Facility for the Elderly Complaint Poster, Ombudsman and Personal Rights posters, and the Theft and Loss Policy. An administrator is on site more than the minimum of 20 hours a week to oversee the proper business operations.

The LPA completed a review of the resident, staff, and facility records. The LPA reviewed the records of 5 residents and 5 staff members. The LPA interviewed 4 staff members.

No citations issued during the inspection.

Exit interview conducted and a copy of this report provided.
Harpreet HumpalTELEPHONE: (510) 529-9416
James SampairTELEPHONE: (510) 286-4201
DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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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