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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200070
Report Date: 11/26/2024
Date Signed: 11/26/2024 12:07:52 PM

Document Has Been Signed on 11/26/2024 12:07 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
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:BRIDGE PROGRAM - PLEASANT HILLFACILITY NUMBER:
079200070
ADMINISTRATOR/
DIRECTOR:		CARSWELL, JOHNFACILITY TYPE:
735
ADDRESS:550 PATTERSON BLVD.TELEPHONE:
(925) 938-8050
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 64CENSUS: 58DATE:
11/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:John Carswell, Campus AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 11/26/2024 at 11:45 am Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Case Management visit regarding requested documents. LPA met with Campus Administrator, John Carswell and explained the purpose of the visit.

LPA requested Face Sheet documents for all residents from the administrator but never received requested documents. Administrator stated that they emailed the documents on 11/15, 11/22 and 11/26. However, LPA never received the documents. LPA collected documents.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE: DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2024
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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