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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370808454
Report Date: 05/30/2024
Date Signed: 05/31/2024 11:12:05 PM

Document Has Been Signed on 05/31/2024 11:12 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:HALCYON CENTERFACILITY NUMBER:
370808454
ADMINISTRATOR/
DIRECTOR:		PRISCILLA GROSSMANFACILITY TYPE:
772
ADDRESS:1664 BROADWAYTELEPHONE:
(619) 579-8685
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 14CENSUS: 12DATE:
05/30/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Program Coordinator Anna SmithTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to follow-up on Plans of Corrections for two (2) deficiencies that were issued during a continuation of an Annual Inspection visit on 04/23/24. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Program Coordinator Anna Smith.

During today’s visit, LPA toured the facility and observed that the bedrooms had all the required furnishings, including dresser drawers. The dresser drawers were also in good condition. LPA also inspected the food in the kitchen and did not observe any spoiled food. The facility implemented a weekly check-in system for food quality.

All Plans of Correction for the two (2) deficiencies were cleared today. No new citations were issued during today's visit.

An exit interview was conducted with Anna, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/30/2024
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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