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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405697
Report Date: 07/08/2021
Date Signed: 07/08/2021 11:07:33 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:FIRST BAPTIST HEAD START - EAST LELAND COURT CTR.FACILITY NUMBER:
073405697
ADMINISTRATOR:ACOSTA, RAMONAFACILITY TYPE:
850
ADDRESS:2555 EAST LELAND ROADTELEPHONE:
(925) 473-2035
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:36CENSUS: 12DATE:
07/08/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Ramona Carrillo, Jajahira GallardoTIME COMPLETED:
11:15 AM
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On 7/8/21 at 10:30 AM Licensing Program Analysts (LPAs) Michelle Sutton and Monica Mathur conducted a case management inspection at the center and met with Site Supervisor, Jajahira Gallardo and Ramona Carrillo. Present in the facility are 3 staff and 12 children.

The purpose of the inspection is to review the amended report, originally dated 6/23/21. LPA reviewed the report with Site Supervisor.

There are no deficiencies being cited today. This report will remain on file for 3 years. An exit interview was conducted and appeal rights were provided.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021
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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