370800930-7-21-2024-08-AS-LSIA-D7E88A-20240721221713

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370800930
Report Date: 07/15/2024
Date Signed: 07/21/2024 10:18:29 PM

Document Has Been Signed on 07/21/2024 10:18 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	ST MADELEINE SOPHIES CENTER		FACILITY NUMBER:	370800930
ADMINISTRATOR/ DIRECTOR:	DEBRA EMERSON		FACILITY TYPE:	775
ADDRESS:	2119 E. MADISON AVENUE		TELEPHONE:	(619) 442-5129
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92019
CAPACITY: 400		CENSUS: 378	DATE:	07/15/2024
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Director of Programming Mark Fisher		TIME VISIT/ INSPECTION COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to continue a Required Annual Inspection, which began on 07/12/24. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Director of Programming Mark Fisher. According to the facility’s license, the facility serves four hundred (400) developmentally disabled adults; ages 18 and above, fifty (50) of whom may be non-ambulatory. During today’s inspection, the facility’s current census was 378. LPA, accompanied by Mark Fisher and Health & Safety Manager Kim Holt, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. The rooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Personal Protective Equipment was available. The facility had sufficient space and equipment to facilitate programs, meetings, activities, and dining. Water temperature at taps accessible to clients were compliant; in bathrooms accessible to clients, there is one neutral water tap that provided lukewarm water. Cooking/dining equipment and utensils were present, and all safely stored. Food was observed to be served in a safe and healthful manner. There were no toxic chemicals/poisons accessible to clients. Medications were properly labeled, as required, and stored in locked areas. [CONTINUED ON LIC 809-C]

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ST MADELEINE SOPHIES CENTER	FACILITY NUMBER: 370800930
	VISIT DATE: 07/15/2024

NARRATIVE

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[CONTINUED FROM LIC 809]
A pool was present on the premises and was surrounded with a fence and locked when not in use. Per Mark Fisher, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present and serviced within the last 12 months. First aid kit(s) were complete and readily accessible.

LPA interviewed staff and clients, and reviewed staff and client records. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in a locked area.

There were no deficiencies observed or cited during today's annual inspection.

An exit interview was conducted with Director of Programming Mark Fisher and Director of Operations, Laura Shanahan, to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

LIC809 (FAS) - (06/04)

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