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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880576
Report Date: 02/07/2023
Date Signed: 02/07/2023 12:16:33 PM

Document Has Been Signed on 02/07/2023 12:16 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:DESERT SERENITY ADULT RESIDENTIAL FACILITY, LLCFACILITY NUMBER:
331880576
ADMINISTRATOR:SPEDALIERE, JOSEPHFACILITY TYPE:
735
ADDRESS:68340 ENCINITAS RDTELEPHONE:
(760) 377-9002
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY: 4CENSUS: 4DATE:
02/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:ADMINISTRATOR, JOSEPH SPEDALIERE.TIME COMPLETED:
12:20 PM
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On February 7, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility for an unannounced required annual with emphasis on infection control.

LPA Mixson met with Administrator introduced self stated the purpose of the visit. LPA toured the facility with Administrator.

Present in the facility were two staff and one resident, other residents and staff were in the community. There are currently no positive cases of COVID-19 within the facility. All Staff and residents are fully vaccinated and Booster ed.

LPA Mixson made observations pertaining to the facility's infection control measures. LPA Mixson observed sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions, and the proper use of face coverings.

The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, and cleaning and disinfection provisions are in adequate quantities.

LPA Mixson later discussed infection control practices and procedures with Administrator.

An exit interview was conducted and a copy of this report was given to Administrator.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2023
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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