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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
073404440
Report Date:
10/17/2024
Date Signed:
10/17/2024 12:38:07 PM
Document Has Been Signed on
10/17/2024 12:38 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
OAKLAND CC RO
,
1515 CLAY STREET, SUITE 1102
OAKLAND
,
CA
94612
FACILITY NAME:
CONTRA COSTA CO. CSD - GEORGE MILLER IIICH.CENTER
FACILITY NUMBER:
073404440
ADMINISTRATOR/
DIRECTOR:
VILLARPANDO, KARLA
FACILITY TYPE:
850
ADDRESS:
300 S. 27TH STREET
TELEPHONE:
(510) 374-3526
CITY:
RICHMOND
STATE:
CA
ZIP CODE:
94804
CAPACITY:
200
TOTAL ENROLLED CHILDREN:
120
CENSUS:
95
DATE:
10/17/2024
TYPE OF VISIT:
Collateral
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:
Ruth Hunter
TIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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LPA D. Campos met with Assistant Director Linda Stafford and Site Supervisor Ruth Hunter for the purpose of reviewing video footage for a different location. LPA was investigating a self reported incident reported to licensing on 9/20/2024 regarding another location.
As a result of this visit no deficiencies were cited today.
Exit interview conducted and report reviewed with Site Supervisor Ruth Hunter.
Notice of Site Visit provided must remain posted for 30 days.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Diana Campos
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/17/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/17/2024
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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