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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405697
Report Date: 11/12/2021
Date Signed: 11/12/2021 03:11:37 PM

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: 8DATE:
11/12/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Jajahira GallardoTIME COMPLETED:
03:15 PM
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On 11/12/21 at 2:15 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Case Management inspection about an unusual incident self reported by the Center about a child left behind in the playground. LPA met with site supervisor Jajahira Gallardo and explained the purpose of today's inspection. All rooms were in ratio compliance during today's inspection.

LPA interviewed the site supervisor and staff. LPA also observed all classrooms and both infant and preschool play yard. Copies of The Children's Roster, Personnel Report LIC500 and incident written statements were obtained.

There are no deficiencies being cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the site supervisor Jajahira Gallardo.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2021
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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