Senior Care Records.

Facility Evaluation Report

Queen Care Home, Castro Valley01/07/2025Licence 019200766

Capacity6
Census6
Date signed01/07/2025 03:58:30 PM
The inspector’s account

On 01/07/2024 at 12:25 PM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Zhei Li and explained the purpose of the visit.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 71 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 108-degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for clients. There is a minimum of one-week supply of non-perishables and 2-day perishables food supply.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 04/23/2024. Emergency Disaster Plan was last posted on 01/04/2024. First aid kit was observed to be complete. Fire drill was last conducted on 12/04/2024.

LPA reviewed 5 clients’ records and 5 staff records, and all were complete. A sample of 3 client’s medications were reviewed. LPA reviewed the following documents during the visit:LIC 500 Personnel Report

LIC 308 Designation of Administrative Responsibility, LIC 400 Affidavit Regarding Client/Resident Cash Resources, LIC 402 Surety Bond, LIC 610D Emergency Disaster Plan.

No deficiencies were cited during this inspection. Exit interview conducted and a copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction