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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407084
Report Date: 02/13/2023
Date Signed: 02/13/2023 02:59:42 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/13/2023 02:59 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 1102
OAKLAND, CA 94612



FACILITY NAME:BRUERE, BERTHAFACILITY NUMBER:
073407084
ADMINISTRATOR:BRUERE, BERTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 327-0316
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:14CENSUS: 8DATE:
02/13/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Bertha BruereTIME COMPLETED:
03:10 PM
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On February 13, 2023 at 1:30pm, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced for a Case Management-Annual Continuation Inspection. LPA met with licensee Bertha Bruere. There were eight children (four infants and four preschool age), and helpers Ana Esquivel Romero and Silvia Cruz Mendez present during the inspection.

During licensee's Required 1-Year inspection conducted on 1/30/23, LPA was unable to review children and staff files as licensee was not home and staff did not have access to files. During today's inspection, LPA observed children's files contain required licensing documents including Infant Sleep Plans for infants up to 12 months old, and an infant sleep log for infants up to 24 months. Licensee's mandated reporter training expires 3/11/23, helper Ana's expires 6/4/24 and Silvia's expires 8/9/24. Licensee's pediatric CPR/first aid expires 2/2025, and both helpers also have current training, expiring in 11/2024.

There are no deficiencies cited during today's inspection.

Exit interview conducted with licensee Bertha Bruere. A Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2023
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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