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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370808438
Report Date: 06/19/2024
Date Signed: 06/20/2024 05:44:35 PM

Document Has Been Signed on 06/20/2024 05:44 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:BAUM ADULT RESIDENTIAL FACILITY, #3FACILITY NUMBER:
370808438
ADMINISTRATOR/
DIRECTOR:		CHERYL BAUMFACILITY TYPE:
735
ADDRESS:9905 CIRCA VALLE VERDETELEPHONE:
(619) 561-7524
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 6CENSUS: DATE:
06/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
11:00 PM
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LPA Liliana Silveira conducted an unannounced visit to conduct an annual inspection. LPA knocked on the facility front door, there was no answer. LPA waited for a period of time and knowledge again, there was no answer. LPA called the facility line and there was no answer. LPA waited in front of the facility for another period of time for someone to arrive.

LPA then called Licensee Cheryl Baum, who stated that the Administrator had taken the clients to the mountains for a day trip and they would not return until late. LPA informed Cheryl that she would return on another day.

No citations were issued during today's visit.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2024
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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