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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200446
Report Date: 07/19/2023
Date Signed: 07/19/2023 03:13:14 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/19/2023 03:13 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:BRIDGESFACILITY NUMBER:
019200446
ADMINISTRATOR:SOKODOLO, KOLU G.FACILITY TYPE:
735
ADDRESS:21259 BIRCH ROADTELEPHONE:
(510) 244-7153
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY: 4CENSUS: 0DATE:
07/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:TIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection and to check the progress of the repair/reconstruction of the facility as a result of fire that happened on November 2022.

The facility was observed vacant and no construction staff on site. LPA observed from outside the living room including the roof and front door damaged.

LPA called and spoke with Regional Director Lorenzo Pennix. LPA informed the reason for visit. Mr. Pennix stated he can not come to the facility at the moment. LPA asked Mr. Pennix dto keep LPA an updated on progress of repair and when construction is completed. LPA further informed that a copy of this report will be provided via email, and requested to sign and return to LPA the signed copy.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2023
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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