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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408199
Report Date: 08/27/2019
Date Signed: 08/27/2019 10:11:22 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: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: 41DATE:
08/27/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Jean KurnikTIME COMPLETED:
10:25 AM
NARRATIVE
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LPA, Hollie, met with Licensee for the purpose of a Case Management visit. Present at the start of the visit were 41 children and eight staff.
During a prior visit, LPA observed that the facility had turned the outside storage area in Building B into a play area for children without prior inspection and sanction from Community Care Licensing. The facility has since ceased to use this area and will submit an application requesting a change in their physical plant space along with an updated outdoor facility sketch. Technical Advice given re: ratio.

The facility was informed that for the health and safety of children in care, once a facility is licensed, physical plant changes cannot occur without inspection and permission from Community Care Licensing.
PLEASE SEE TYPE BE DEFICIENCY REGARDING PHYSICAL PLANT CHANGES.
SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2019
Section Cited

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101237 Alterations to Existing Buildings or New Facilities (a) Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s). THIS REQUIREMENT WAS NOT BEING MET.
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During a prior visit to the facility, LPA observed that the facility had changed the OFF LIMIT/Storage Area in Building B, to a Play Yard for children without prior consent and review from Licensing. The facility has ceased using this area.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 08/27/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2019
LIC809 (FAS) - (06/04)
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