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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 134602532
Report Date: 04/06/2022
Date Signed: 04/07/2022 10:42:50 AM

Document Has Been Signed on 04/07/2022 10:42 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:DAYOUT ADHC/ALZHEIMER DAY CARE RESOURCE CENTERFACILITY NUMBER:
134602532
ADMINISTRATOR:ELIZABETH MACHADOFACILITY TYPE:
775
ADDRESS:757 MAIN STREETTELEPHONE:
(760) 337-8394
CITY:EL CENTROSTATE: CAZIP CODE:
92243
CAPACITY: 10CENSUS: 0DATE:
04/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Program Director, Maribelle MendezTIME COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required - 1 Year visit. LPA met with Program Director, Maribelle Mendez, and we discussed the purpose of the visit.

This facility has a dual license. The Adult Day Health Center (ADHC) is licensed by another State agency. The Alzheimer Day Care Resource Center is licensed by this Department. Mendez stated the license from CCLD is kept active in case funding for the day program is reinstated. At this time, there are no clients in care for the day program licensed by CCLD. It was reported all individuals on site during today's visit, were participating in the ADHC.

LPA conducted a tour of the area where CCLD-monitored clients would be situated during program. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff. Signs posted at facility entrance and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff; and an adequate supply of PPE (Personal Protective Equipment). Based on observations, the facility is in compliance with and has implemented infection control practices as outlined in its Mitigation Plan (LIC 808).

No deficiencies were observed during today's visit. An exit interview was conducted with Program Director, Maribelle Mendez, and copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail. Email receipt confirmation will confirm receipt of this report.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022
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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