Facility Evaluation Report

A & K Residential Home, Hayward03/28/2025Licence 019200681

Capacity6
Census3
Date signed03/28/2025 03:44:30 PM
Name of licensing program analystAlicia Delmundo
Name of licensing program managerBennett Fong
The inspector’s account

On this day, March 28, 2025 at 11:30 am, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA rang the doorbell; no answer. LPA called and sent text message to Kiptiatu Iscandari, licensee. LPA also called and sent text message to Mohamed Conteh, administrator (ADM). Licensee and ADM both responded to LPA. ADM arrived at around 11:55 am. Mumcy Coker, staff, arrived after several minutes.

LPA inspected the kitchen, dining area, living room, bedrooms, bathrooms, front, side and backyard. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications and storage for cleaning supplies were observed locked.

Facility has carbon monoxide and smoke detectors that were tested and observed in operating condition. Facility conducts fire and earthquake drills at least every quarter, and records showed earthquake drill last conducted 2/10/25. Ho t water temperature in the one of the bathrooms was tested and measured at 119.7 degrees Fahrenheit. Fire extinguisher checked, observed fully charge with tag showed serviced 6/23/24.

LPA reviewed 3 residents and 5 staff files. Residents medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Residents' P&Is were checked and compared with last recorded balance.

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