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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015601394
Report Date: 03/20/2025
Date Signed: 03/20/2025 05:14:20 PM

Document Has Been Signed on 03/20/2025 05:14 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:SAN LEANDRO SENIOR LIVINGFACILITY NUMBER:
015601394
ADMINISTRATOR/
DIRECTOR:		BERTUCCI, GLENDA TFACILITY TYPE:
740
ADDRESS:348 W JUANA AVETELEPHONE:
(510) 357-1691
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY: 90CENSUS: 50DATE:
03/20/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:05 PM
MET WITH:Glenda Bertucci, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
05:20 PM
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On 3/20/2025 at 4:05PM, Licensing Program Analysts (LPAs) G. Luk and Y. Brown arrived unannounced to conduct a case management visit in regards to an incident report. LPAs met with Executive Director (ED), Glenda Bertucci and explained the purpose of the visit.

Based on the incident report, facility have been sending emails and tried to call R1 without response. On 3/10/2025, facility observed R1 was not in his apartment. Facility contacted R1's family and they did not know R1's whereabouts. R1's family informed facility that he will contact the police to file a missing person's report. Police made a visit to the facility to conduct investigation.

During visit, LPAs interviewed staff and reviewed R1's file including physician's report, decline services document, and incident report. R1's physician's report stated that R1 can leave the facility unassisted. Interview with staff revealed that family have been providing updates on police investigation.

No deficiencies are being cited on this date.

LPAs may return on a later date.

Exit interview conducted with Glenda Bertucci. A copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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