Inspection
No deficiencies recorded in this report
HEAVEN PLACE CARE HOME
14724 PEPPERDINE ST, San Leandro CA 94579
6 bedsLatest official report Nov 18, 2025Licensed
Additional info
- Telephone
- (510) 969-7966
- Licensee
- HEAVENLY PLACE CARE HOME LLC
- Administrator
- ADAMS, JACQUELINE
- Contact
- ADAMS, JACQUELINE
- License first date
- Nov 23, 2022
- License effective date
- Nov 23, 2022
- District office
- OAKLAND ASC · (510) 286-4201
- Regional office
- 15
- Clients served
- 983 - RCFE / DEMENTIA, 985 - RCFE / HOSPICE
Summary
The available records show 5 Type B deficiencies for this facility.
- Most recent inspection
- Nov 18, 2025
- Most recent deficiency
- Jan 27, 2024
2 later reports, from Nov 18, 2024 through Nov 18, 2025, recorded no deficiencies, though the records do not say whether they were follow-ups.
What Type A and Type B mean
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 152 Alameda County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 4 reports for this facility: 3 inspections, 0 complaint investigations, and 1 licensing or administrative record.
Those records contain 0 Type A and 5 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 3
- Recorded deficiencies
- 5
- Type A deficiencies
- 0
- Type B deficiencies
- 5
- Substantiated complaints
- 0
- Repeated topics
- 0
Fewer than the typical 4
1 in the last 12 months
More than the typical 4
0 in the last 12 months
Fewer than the typical 1
0 in the last 12 months
More than the typical 2
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
No topic repeats in the last 36 months
No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
No deficiencies recorded in this report
Inspection
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87305(b)
- Regulation authority
- CCR
What the official deficiency says
87305 Alterations to Existing Building or New Facilities (b) The licensing agency may require the facility to acquire a local building inspection where the agency determines that a suspected hazard to health and safety exists. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in having garage inspected for living quarters for staff which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/05/2024 Plan of Correction Administrator agreed to submit an updated facility sketch and LIC200 to CCLD by POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87307(d)(6)
- Regulation authority
- CCR
What the official deficiency says
87307 Personal Accommodations and Services (d) The following space and safety provisions shall apply to all facilities: (6) All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in have passageway in back yard free of obstruction which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/05/2024 Plan of Correction Administrator agreed to remove items and submit photos to CCLD by POC date.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(f)
- Regulation authority
- CCR
What the official deficiency says
87412 Personnel Records (f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in having personnel records available for review which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/05/2024 Plan of Correction Administrator agreed to review regulation 87412 and submit a self-certification stating the regulation have been reviewed and the facility will abide by the regulation going forward to CCLD by POC date.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87506(d)
- Regulation authority
- CCR
What the official deficiency says
87506 Resident Records (d) All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in have resident records available for review which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/05/2024 Plan of Correction Administrator agreed to review regulation 87506 and submit a self-certification that the regulation have been reviewed and the facility will abide by the regulation going forward to CCLD by POC date.
Plan of correction recorded
Correction not verified in available records
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(e)
- Regulation authority
- CCR
What the official deficiency says
87465 Incidental Medical and Dental Care (e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician, on a prescription blank, maintained in the residents file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in having medications labeled and medication written on MAR which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/05/2024 Plan of Correction Administrator agreed to update the medical administrator record (MAR) and submit a self-certification that it has been done, and medication is put in a labeled medication bottle. Self-certification shall be submitted by POC date.
Plan of correction recorded
Correction not verified in available records
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology