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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200765
Report Date: 11/01/2024
Date Signed: 11/01/2024 12:47:55 PM

Document Has Been Signed on 11/01/2024 12:47 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:PLEASANT HILL OASISFACILITY NUMBER:
079200765
ADMINISTRATOR/
DIRECTOR:		ELEGADO, LIZAFACILITY TYPE:
740
ADDRESS:40 BOYD RDTELEPHONE:
(925) 937-5348
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 49CENSUS: 48DATE:
11/01/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Liza Elegado, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 11/01/2024 at 9:30 AM, Licensing Program Analysts (LPAs) L. Alexander and D. Doidge arrived unannounced to conduct a Plan of Correction (POC) visit. LPAs met with Business Office Manager, Reynaldo "Jun" Gutierrez and explained the purpose of the visit. Jun called the Executive Director, Liza Elegado to inform. Liza arrived shortly after.

On 10/08/2024, LPA conducted an Annual visit in which deficiencies were cited. The POC due dates was 10/24/24, 10/25/24, 10/31/24, 11/08/24 and 11/15/24. Administrator failed to submit the POC by the due dates and this is why LPAs came to make a POC visit.

Deficiencies cleared:

87555(b)(16)
87463(a)
87506(a)(b)
87458(b)(1)
87211(a)(1)
Deficiencies not cleared:

87211(a)(1) = $100 X 6 = $600.00
87458(C) = $100 X 1 = $100.00

Civil Penalties in the total amount of $700.00 is assessed today for failure to meet POC date for deficiencies. Facility is subject to ongoing daily civil penalties until deficiencies is corrected.

Exit interview conducted. A copy of this report, appeal rights provided and LIC421FC provided.




SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024
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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