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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410811
Report Date: 01/31/2024
Date Signed: 01/31/2024 03:48:20 PM


Document Has Been Signed on 01/31/2024 03:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:COMMUNITY BRIDGES EED REDWOOD MOUNTAIN CENTERFACILITY NUMBER:
444410811
ADMINISTRATOR:ALORA BONDFACILITY TYPE:
850
ADDRESS:7103A HIGHWAY 9TELEPHONE:
(831) 400-1160
CITY:FELTONSTATE: CAZIP CODE:
95018
CAPACITY:20CENSUS: 4DATE:
01/31/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Alora BondTIME COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst(LPA) Jessica Bongardt met with Alora Bond for an unannounced Case Management Visit. LPA was at the facility for another issue and while touring the facility saw some fencing that did not meet Title 22 regulations. There is a part of the fence that is missing on the right hand side that is just covered by toy sheds to keep the children from leaving the playground. Also on the left hand side of the fence there was a hole made and is closed by zip ties and plastic chicken fencing which is also covered by a playhouse so you can not see it from the inside of the playground.

These items cause safety issues to the children in care. A Type B citation will be issues for these deficiencies.

Exit interview was conducted with Site Supervisor Alora Bond, and appeal rights were given.

Notice of site visit was issued and must be posted for 30 days.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510)-566-5850
LICENSING EVALUATOR NAME: Jessica BongardtTELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024
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 2


Document Has Been Signed on 01/31/2024 03:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131


FACILITY NAME: COMMUNITY BRIDGES EED REDWOOD MOUNTAIN CENTER
FACILITY NUMBER: 444410811

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/14/2024
Section Cited
CCR
101238.2(g)(1)

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Lack of fencing on the playground which poses a serious safety hazard to the children in care

This requirement is not met as evidenced by
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Director will get LPA a plan on how the fencing will be corrected to meet Title 22 Regulations as stated in 101238.2(g)(1)
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Based on observation there was a lack of fencing in the back playground which poses a potential safety risk to the children in care
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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: Gladys KuizonTELEPHONE: (510)-566-5850
LICENSING EVALUATOR NAME: Jessica BongardtTELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024
LIC809 (FAS) - (06/04)
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