Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management Visit to observe the physical plant. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Noe Contreras.

On 09/06/2024, the Licensee submitted an LIC200 Application to the CCLD San Diego Regional Office (RO) requesting to decrease the facility's total licensed capacity from five (5) clients down to four (4) clients. The facility’s floor plan remained unchanged.

On 10/03/2024, the local fire authority approved/granted an updated fire clearance, reflecting the facility was approved for four (4) clients in total, of whom all may be ambulatory or non-ambulatory, but none may be bedridden.

During today’s visit, LPA briefly toured the interior and exterior of the facility. The facility sketch/floor plan was consistent with the current layout of the facility. Per LIC602 Physician’s Reports, staff interviews, and LPA observation: There were a total of four (4) clients in care, all of whom were non-ambulatory.

No deficiencies were observed or cited during today's visit.

This portion of the application process has been completed. The Licensee will be sent an updated license to reflect the new fire clearance after CCLD management’s final review and approval.

An exit interview was conducted with Contreras. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided to the Licensee during today's visit.