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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370808288
Report Date: 03/15/2022
Date Signed: 03/31/2022 07:24:14 PM

Document Has Been Signed on 03/31/2022 07:24 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, 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: 6DATE:
03/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Caregiver Jacob Carroll and Back-up Director Dana MaddenTIME COMPLETED:
04:45 PM
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***THIS IS AN AMENDED VERSION OF THE ORIGINAL REPORT CREATED ON 03/15/22. THE CORRECT INSPECTION DATE WAS 03/22/22, CENSUS: 3, TIME BEGAN: 1:45 PM, TIME COMPLETED: 03:30 PM. Licensing Program Analyst (LPA), Liliana Silveira conducted an unannounced annual required licensing inspection. LPA identified herself, disclosed the purpose of the visit and was granted entry by Jacob Carroll. The inspection included a tour of the facility and verifying compliance with statutes, regulations and other written requirements that are most relevant to protecting the health of residents in care and staff, including in the area of infection control practices.

LPA reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC 808) with back-up Director Dana Madden, including the following sections: Person in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility Plans for Infection Control and Physical Distancing. LPA assessed the strategies that the facility is employing for the prevention, containment and mitigation of COVID-19, implementation of infection control guidance, staff retention and essential health and safety.

LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; a sign at facility entrance with the facility’s visitor policy and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff and encouraged for residents; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE. The facility is in compliance with and has implemented infection control practices as outlined in its LIC 808.

Based on today’s inspection, no deficiencies were observed. An exit interview was conducted with Dana Madden. A copy of this report, along with the Licensee Rights (9058 01/16) was emailed to Licensee Linda Turman. An electronic response confirms the receipt of these documents.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2022
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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