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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370808447
Report Date: 10/31/2022
Date Signed: 10/31/2022 02:44:18 PM

Document Has Been Signed on 10/31/2022 02:44 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:DEL SUR CRISIS CENTERFACILITY NUMBER:
370808447
ADMINISTRATOR:DAY, MICHAELFACILITY TYPE:
772
ADDRESS:892 27TH STREETTELEPHONE:
(619) 575-4687
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY: 12CENSUS: 9DATE:
10/31/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:46 PM
MET WITH:Administrator, Michael DayTIME COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA), Marisela Garcia-Centeno, conducted a case management visit to follow-up and provide guidance on observations made during the annual required inspection. LPA was granted entry into the facility by Administrator, Michael Dayl, to whom LPA identifying herself and disclosed the purpose of the visit.

During the a required annual inspection, the LPA provided guidance to facility staff regarding visitation policies, a sign-in policy needs to be enacted for all visitors, a visitor station by the entry area needs to be equipped with screening supplies and Personal Protective Equipment, need to update signs on the walls in the kitchen and bathroom areas to promote hand washing and disinfection, add a few more hand sanitizer dispensers throughout the facility and needs to submit a revised Emergency Disaster Plan LIC 610D. Once N95 fit testing completed on November 1, 2022, Administrator agreed to forward documentation CCL. In addition, LPA reviewed safety protocols when transporting clients to and from medical appointments.

An exit interview was conducted with Administrator, Day, to whom a copy of the report and Licensee/Appeal Rights (LIC 9058 01/16) were provided at the conclusion of the visit.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE: DATE: 10/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2022
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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