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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407208
Report Date: 11/29/2023
Date Signed: 11/29/2023 11:37:07 AM

Document Has Been Signed on 11/29/2023 11:37 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CERTEZA, ATHENAFACILITY NUMBER:
073407208
ADMINISTRATOR:CERTEZA, ATHENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 305-7377
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
11/29/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Athena CertezaTIME COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced case management inspection. LPA first met with licensee's assistant, Lelani Certeza. Athena Certeza arrived approximately 30 minutes after LPA. Licensee's fingerprint cleared husband and minor child that is not counted in the ratio were also present during the inspection. There were 4 infants and 3 preschool aged children in care.

Licensee has recently installed an in ground pool. LPA conducted an inspection of the backyard and pool area. Licensee has a five foot mesh fence that does not obstruct the view of the pool. The fence has a self latching gate that opens away from the pool. There was a gap between the mesh fence and the wooden backyard fence. The contractor arrived to the home to fix the fence during the inspection. The fence was repositioned during the visit to ensure there were no longer gaps between the fences for children's safety. The backyard is observed to be safe for children in care and is approved to be on limits for children. Licensee and LPA spoke about pool safety. Licensee agrees to have 100% supervision during water play with children.

Exit interview and report reviewed with Athena Certeza.
Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2023
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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