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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201221
Report Date: 01/16/2025
Date Signed: 01/16/2025 01:00:57 PM

Document Has Been Signed on 01/16/2025 01:00 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:G & O RESIDENTIAL INC.FACILITY NUMBER:
079201221
ADMINISTRATOR/
DIRECTOR:		OVLIO BARRIOS GARCIAFACILITY TYPE:
735
ADDRESS:1500 CAJON CTTELEPHONE:
(925) 565-5731
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 4CENSUS: 4DATE:
01/16/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Ovilio Barrios Garcia, AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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On 1/16/2025 at 12:40pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced Case Management visit to amend and LIC9099A that was created on 1/3/2025. LPA met with Ovilio Barrios Garcia, Administrator, and explained the purpose of the visit.

LPA L. Hall unsubstantiated an allegation of “Staff are not reporting incidents involving resident as required.” LPA did not add allegation to the allegation box on the 9099A. LPA corrected LIC9099A, had document signed, and printed a copy for the facility.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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