Facility Evaluation Report

Glen Eden, Hayward09/16/2025Licence 019201125

Capacity4
Census4
Date signed09/16/2025 12:10:18 PM
Name of licensing program analystKelly Nguyen
Name of licensing program managerBennett Fong
The inspector’s account

On 9/16/2025 at 10:15AM, Licensing Program Analyst (LPA) K. Nguyen conducted a Case Management visit regarding an incident report received on 9/16/2025. LPA met with Administrator Maria Fatima Lacsamana and explained the purpose of the visit.

Based on the incident report received on 9/16/2025, R1 left the facility without notifying staff on 9/12/2025, however S1 followed R1the entire time. R1 returned to the facility after an hour with S1 behind R1. After a few minutes of R1 called, Hayward Police Department requested to be taken to John George.

LPA conducted interviews with R1 and S1 shows that S1 was following R1 the entire time.

LPA reviewed R1 physician Report shows that R1 cannot leave the facility unassisted, however R1 is receiving 10hr 1:1 service until bedtime.

An exit interview is conducted and a report is provided.

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