<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408199
Report Date: 09/13/2019
Date Signed: 09/13/2019 03:49:02 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:CENTER OF GRAVITY, INC.FACILITY NUMBER:
073408199
ADMINISTRATOR:BREHOB,K & KURNIK,J.FACILITY TYPE:
850
ADDRESS:2702 PLEASANT HILL RD.TELEPHONE:
(855) 323-7836
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:60CENSUS: 52DATE:
09/13/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Utami SetiyadiTIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
A Case Management Visit was conducted today, September 13, 2019 by Licensing Program Manager (LPM) Wynn Norona. LPM met director, Utami Setiyadi. An application was submitted requesting additional outdoor activity space for children with no change in capacity. There are 52 preschool children with 9 fingerprint cleared staff present today.
A health and safety inspection was conducted inside and outside. The following is the new and updated overall measurement:

INDOORS: 2826.89 square feet- (no change based on 5/25/16 measurement)
OUTDOORS: 7894.95 square feet (based on 5/25/16 measurement) plus
225 square feet (today's measurement)
Updated Outdoor measurement: 8119.95 square feet

LPM advised the director to send an amended LIC200A and copy of Board Resolution designating the director as the applicant on behalf of the Corporation or have the original applicant sign the LIC200A. An exit interview was conducted with Ms. Setiyadi. Zero Tolerance policies were explained. LPM provided a copy of the appeal rights and the signature on this form acknowledges receipt of these rights. LPM reminded the director that the facility must be in compliance with all licensing laws and regulations. If the center is in violation of any laws or regulations, a citation will be issued. Notice of Site Visit form was provided and posted.

Effective today, September 13, 2019, the center is approved for the additional outdoor play space behind Building B for children’s use.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1