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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408199
Report Date: 06/17/2021
Date Signed: 06/17/2021 11:24:10 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:SETIYADI, UTAMIFACILITY TYPE:
850
ADDRESS:2702 PLEASANT HILL RD.TELEPHONE:
(925) 954-8399
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:60CENSUS: 44DATE:
06/17/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Utami SetiyadiTIME COMPLETED:
11:30 AM
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
On 06/17/21 at 9:00 AM Licensing Program Analysts (LPAs) Monica Mathur and Michelle Sutton conducted an unannounced Case Management inspection about a unusual incident self reported by the Center about a parent allegation that a child inappropriately touched another child. LPAs met with Director, Utami Setiyadi and explained the purpose of today's visit. Facility is operating in 6 groups of children - Researcher (Blue & Orange); Engineer (Blue & Orange), Architect (Blue & Orange). All groups were in ratio compliance during today's inspection.

LPAs interviewed the Director, staff and children, reviewed staff and children files. LPA also observed classrooms. The Children's Roster, Personnel Report LIC500, Copies of internal notes were obtained, and children information gathered.

No deficiencies were issued during today's visit. Exit Interview was conducted, where this report was reviewed and discussed with the Director.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021
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