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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600874
Report Date: 01/09/2025
Date Signed: 01/09/2025 01:14:52 PM

Document Has Been Signed on 01/09/2025 01:14 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BROOKDALE REDWOOD CITYFACILITY NUMBER:
415600874
ADMINISTRATOR/
DIRECTOR:		MONICA CERON TAPIAFACILITY TYPE:
740
ADDRESS:485 WOODSIDE RDTELEPHONE:
(650) 366-3900
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 130CENSUS: 66DATE:
01/09/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Monica Ceron-Tapia, Executive Director TIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On 1/9/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility at 9:00 AM to continue the 1-year required Annual Inspection. LPA was greeted by Monica Ceron-Tapia, Executive Director and explained the purpose of the visit.

LPA toured the physical plant. Hot water temperature was measured within the 105-120 degrees Fahrenheit.

LPA Calandra reviewed 6 resident records. All were observed to be complete.

A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication records kept at the facility.

LPA requested copies of the following documents be sent to the Department by 1/16/2025:
  • Current LIC 500
  • Liability Insurance

No deficiencies were cited during today's visit.

An exit interview was conducted. A copy of the report was left at the facility.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
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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