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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200941
Report Date: 11/21/2024
Date Signed: 11/21/2024 02:03:13 PM

Document Has Been Signed on 11/21/2024 02:03 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:OAKRIDGE HOME-SUNVIEWFACILITY NUMBER:
079200941
ADMINISTRATOR/
DIRECTOR:		PIZZAGONI, INGREDFACILITY TYPE:
735
ADDRESS:5541 SUNVIEW WAYTELEPHONE:
(925) 775-4628
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY: 6CENSUS: 6DATE:
11/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Mike Nubla, AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 11/21/24 at 1PM, LPA D Panlilio conducted an unannounced case management visit to discuss C1's incident reports regarding her behavioral aggressions and elopement tendencies. Administrator is actively working with Regional Center of the East Bay (RCEB) in addressing her needs as well as communicating with C1' s responsible party and primary care physicians.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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