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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200525
Report Date: 11/15/2024
Date Signed: 11/15/2024 05:14:21 PM

Document Has Been Signed on 11/15/2024 05:14 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:CARING ANGELS CARE HOMEFACILITY NUMBER:
079200525
ADMINISTRATOR/
DIRECTOR:
JOHNNY BARROSAFACILITY TYPE:
740
ADDRESS:3107 DEL OCEANO DRIVETELEPHONE:
(925) 943-5087
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
11/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:50 PM
MET WITH:Johhny Barrosa, Administrator TIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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On 11/15/2024 at 2:50 pm, Licensing Program Analysts (LPAs) David Doidge and Lisha Holmes arrived unannounced to conduct an Annual 1-year required inspection. LPAs met with Administrator Johnny Barrosa, and explained the reason for the visit.

LPAs inspected the facility , which included but not limited to the bathrooms, kitchen, common areas, and the outside area of the facility. LPAs observed the facility to be free of odor, clean and in good repair. Outdoor space is provided and is free of hazards. There is a comfortable room temperature of 72 degrees Fahrenheit. The hot water temperature in the shared bathroom measured 110.8 degrees. All observed toilets and hand washing stations are maintained in a safe, sanitary, operating condition. There are no bodies of water or fire safety hazards observed. Carbon monoxide and smoke fire alarms found to be in working order. Toxins and sharp objects were locked and inaccessible to participants. Fire extinguisher last services 10/23/2023. Fire drills are conducted once every other month, last 12/13/2023. First aid kit was checked and is complete.

LPAs reviewed two (2) staff files and six (6) resident files. All were current and complete.

No deficiencies were cited during this inspection. One


Exit interview conducted and a copy of this report provided.
Bennett FongTELEPHONE: (510) 286-4201
David DoidgeTELEPHONE: (916) 475-5913
DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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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