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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370808288
Report Date: 09/30/2021
Date Signed: 10/01/2021 08:46:53 AM

Document Has Been Signed on 10/01/2021 08:46 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:TURMAN'S CLARENDON HOUSE IFACILITY NUMBER:
370808288
ADMINISTRATOR:KELLY GALLOWAYFACILITY TYPE:
735
ADDRESS:1280 CLARENDON STREETTELEPHONE:
(619) 588-5493
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 6CENSUS: 5DATE:
09/30/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Administrator, Kelly GallowayTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA), Alexandre Vo, and the County of San Diego Public Health Nurses, Jennifer West, Robert Montillano, and Elizar Perez conducted an on-site HAI assessment visit. LPA Vo and team identified themselves and discussed the purpose of the visit with Administrator, Kelly Galloway.

The Department conducted an on-site visit to provide technical assistance and to evaluate the facility's mitigation plan to include disinfection, testing, vaccination, and screening protocols as well as the use of personal protective equipment (PPE). During today's visit, LPA Vo and team conducted a walk-though of the facility. A debriefing was conducted with Administrator Galloway at the conclusion of the visit.

No deficiencies were cited during today's visit. An exit interview was conducted with Administrator Galloway and a copy of this report, along with Licensee Rights (LIC 9058 01/16), were provided to the Administrator via electronic mail. An electronic receipt of confirmation was requested to be sent from the Administrator upon receipt of the documents.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Alexandre Vo
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2021
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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