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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801433
Report Date: 08/25/2021
Date Signed: 08/25/2021 11:51:27 AM

Document Has Been Signed on 08/25/2021 11:51 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:BRIGHTER TOMORROWSFACILITY NUMBER:
565801433
ADMINISTRATOR:CHRISTOPHER BLUMFACILITY TYPE:
772
ADDRESS:1750B SOUTH LEWIS ROADTELEPHONE:
(805) 383-3669
CITY:CAMARILLOSTATE: CAZIP CODE:
93012
CAPACITY: 15CENSUS: 13DATE:
08/25/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Christopher BlumTIME COMPLETED:
11:55 AM
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Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced Case Management site visit with the purpose of following up on a default Decision and Order served on Staff #1 (S1). LPA Dulek met with Administrator Christopher Blum for a Confirmation of Removal visit.

A default Decision and Order was ordered on July 27, 2021, and became effective August 8, 2021, that S1 is excluded from any care facility licensed by the Department. Therefore, S1 was required to be removed from the facility. Administrator stated that S1 was terminated on 2/19/2021.

During this visit, Administrator Blum provided LPA Dulek a copy of the current personnel report to verify S1 is no longer working at the facility. During today’s visit, S1 was not observed in the facility at this time.

No citations issued during today's visit.

Exit interview was conducted with Administrator, and a copy of the report was provided via email.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2021
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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