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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197603121
Report Date: 11/26/2024
Date Signed: 11/26/2024 01:10:38 PM

Document Has Been Signed on 11/26/2024 01:10 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:BRU JR FAMILY HOMEFACILITY NUMBER:
197603121
ADMINISTRATOR/
DIRECTOR:		BRU, LUIS JRFACILITY TYPE:
735
ADDRESS:1210 EAST DONATELLO STTELEPHONE:
(661) 816-3411
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 4CENSUS: 4DATE:
11/26/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Luis Bru Jr.TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Lorena Casillas arrived at 09:00 for an annual required inspection. LPA was greeted by Administrator Luis Bru Jr. and an entrance interview conducted.

LPA and the Administrator conducted a tour of the facility at 11:30 am. The following was observed:

All clients were at day program or out in the community.

Infection control: LPA reviewed infection control plan approved on 10/17/2022 to make sure the licensee was following current infection control recommendations.

Kitchen: LPA conducted a food inspection tour at 11:40 am. LPA observed there to be sufficient stock of two- perishable and seven-day non-perishables foods. The menu was posted for review. Snacks and beverages are available for clients in the facility when they want. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and medication are stored in a locked staff room inaccessible to clients.

Common Areas: LPA toured all common areas of the facility. LPA observed common areas to be clean and furniture to be in good repair. The facility maintains a comfortable temperature at 73 degrees F. LPA observed fire extinguishers to be full and last serviced on 06/12/2024.

Client rooms: LPA toured the client rooms at 11:50 am. LPA observed rooms to have appropriate bedding sheets, pillowcase, mattress pad, and blankets, which are in good condition. There is at least one chair, night stand and sufficient lighting for each client. LPA observed extra linens and bedding in a hallway closet.

Continued on LIC809-C
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: BRU JR FAMILY HOME
FACILITY NUMBER: 197603121
VISIT DATE: 11/26/2024
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Bathrooms: LPA observed bathrooms to have appropriate wash your hand signs. LPA observed that clients have sufficient number of supplies for personal hygiene which is provided by the Licensee. The hot water measured within regulation at 117.5 degrees F.

Outside areas: LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for clients. No pools or bodies were observed on the premises.

Garage: LPA observed there to be an attached garage that is used to store emergency water, extra PPE equipment and used for general storage. Washer and dryer are located in the garage and detergents are stored in a locked cabinet.

Client Records: At 11:00 am LPA reviewed client records.

Staff Records: At 11:30 am LPA reviewed staff records.

Interviews: There were no clients present at the time of inspection. All clients are currently at day program. LPA interviewed Administrator.

Medication: At 12:20 pm LPA and Administrator reviewed client medication.

Administrative: Annual fees are current. Administrator will email LIC500, Bond, and Resident roster. Administrator has sent in all required documents for Admin Certificate renewal, however they are currently on a pending list. Once Admin Certificate is received Administrator will email it to LPA.

No citations issued. Exit interview conducted. Copy of report delivered to Administrator.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
LIC809 (FAS) - (06/04)
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