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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 216803245
Report Date: 06/14/2024
Date Signed: 06/14/2024 10:39:14 AM


Document Has Been Signed on 06/14/2024 10:39 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:COMFORTING HANDS FOREVER,LLCFACILITY NUMBER:
216803245
ADMINISTRATOR:BIERKE, EVERDINAHFACILITY TYPE:
740
ADDRESS:73 GOLDEN HINDE BLVDTELEPHONE:
(415) 479-1900
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY:6CENSUS: 6DATE:
06/14/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Licensee, Everdinah Bierke, and Applicant, Stephanie EllazarTIME COMPLETED:
10:45 AM
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An Office meeting was conducted today in the Santa Rosa Regional Office. The following individuals were present in the meeting: Licensing Program Manager, Victoria Bertozzi, Licensing Program Analyst, Caitlynn Felias, Licensee, Everdinah Bierke, and Applicant, Stephanie Ellazar. The purpose of the office meeting was to hold an informal meeting to address areas of concern identified by the Department. The following areas were discussed during the meeting today:
  • Operational Duties of the Licensee
  • Change of Ownership Application Status
  • Administrator Duties


Parties discussed the Change of Ownership and how the transition is going. Current Licensee expressed that they are still able to maintain the Administrator duties and plans to remain the Administrator until the Applicant is licensed.

CCL has agreed to request that the application is expedited.

No Deficiencies Cited during office meeting.

Exit interview conducted. Copy of report discussed and provided to Licensee and Applicant. Signature on form confirms receipt of documents.
SUPERVISOR'S NAME: Victoria BertozziTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Caitlynn FeliasTELEPHONE: 707-588-5039
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2024
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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