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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201268
Report Date: 05/16/2023
Date Signed: 05/16/2023 10:37:16 AM

Document Has Been Signed on 05/16/2023 10:37 AM - 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 CARE, INCFACILITY NUMBER:
079201268
ADMINISTRATOR:GARCIA, OVILIO BARRIOSFACILITY TYPE:
735
ADDRESS:1550 LARKSPUR CTTELEPHONE:
(925) 565-5731
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY: 4CENSUS: 0DATE:
05/16/2023
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ovilio Garcia, Licensee/AdministratorTIME COMPLETED:
10:55 AM
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On 5/16/2023 at 10:00AM, Licensing Program Analyst (LPA) G. Luk conducted a face to face Component III presentation. LPA met with Licensee/Administrator, Ovilio Garcia.

LPA presented Component III power point and discussed the regulations embodied in the presentation. LPA observed Licensee/Administrator gained knowledge about running and maintaining the facility in accordance with Title 22 regulations.

LPA concluded Component III.

Exit interview conducted with Ovilio Garcia and a copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2023
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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