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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200765
Report Date: 05/11/2023
Date Signed: 05/11/2023 04:58:31 PM


Document Has Been Signed on 05/11/2023 04:58 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:ELEGADO, LIZAFACILITY TYPE:
740
ADDRESS:40 BOYD RDTELEPHONE:
(925) 937-5348
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:44CENSUS: 44DATE:
05/11/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:08 PM
MET WITH:Reynaldo "Jun" Gutierrez, Business Ofiice ManagerTIME COMPLETED:
02:45 PM
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On 05/11/2023 at 2:08 PM, Licensing Program Analyst (LPA) L. Alexander and Licensing Program Manager J. Fong arrived unannounced to conduct a POC (proof of correction) inspection. LPA and LPM met with Business Office Manager, Reynaldo "Jun" Gutierrez.

The following deficiencies was cited on 04/28/2023 as a result of a case management visit and cleared by visit:

- 87202(a); LPAs observed that R1 was occupying a room that did not have a fire clearance. LPA and LPM observed that R1 has been moved and the room has been cleared. LPA cleared POC and provided a copy of the POC letter.

- 87307(d)(2); LPAs observed that facility was not being maintained, with unlocked sheds, weathered doors and other miscellaneous items in disrepair at the building's exterior. LPA and LPM observed that the locks were placed on all sheds outside, all doors had locks attached, weathered doors were replaced and accumulated items outside was removed, cleared and cleaned up.

Exit interview conducted. A copy of this report provided.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Lori Alexander-WashingtonTELEPHONE: (510) 285-3934
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2023
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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