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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 371881367
Report Date: 03/03/2023
Date Signed: 03/03/2023 10:51:22 AM

Document Has Been Signed on 03/03/2023 10:51 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:AVID BEHAVIORAL DAY PROGRAM - CIVICFACILITY NUMBER:
371881367
ADMINISTRATOR:MAHARAJ, LORENAFACILITY TYPE:
775
ADDRESS:510 CIVIC CENTER DR SUITE ETELEPHONE:
(858) 442-6840
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY: 15CENSUS: 0DATE:
03/03/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Applicant Lorena MaharajTIME COMPLETED:
10:55 AM
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Licensing Program Analyst (LPA) Janira Arreola, conducted an announced visit for the purpose of conducting the prelicensing inspection on 3/3/2023 at 9:40 a.m. LPA met with applicants Sarai Marcelin and Lorena Maharaj for the visit. The applicant is seeking an initial application for an adult day program care for the adults with a capacity for (15) residents, ages 18 to 59.

LPA conducted a walk through of the interior of the facility. The facility is located in Suite E of business offices and is a (3) room and (1) bathroom, one story suite. The fire clearance conducted on 12/6/2022 by Vista Fire Department and was approved for (15) ambulatory clients. LPA observed all pathways, ramps, and fire exits were free from obstructions. LPA observed (1) charged and inspected fire extinguisher near the main entrance, and observed the pull fire alarm and dual carbon monoxide alarms through the facility. The activity rooms were observed to have enough seating and activity space for clients and observed (1) room that would be used as an isolation room with PPE supplies and a bed for quarantining clients. First aid kits were observed in facility medication cart where client medications will be stored, as well as well as sharp objects. The facility had a fridge for keeping clients lunches and has snacks and snack menu. Mini fridge was observed under counter in the main common room where client medications will be kept locked. LPA observed the bathroom in the facility to have hand hygiene supplies, and personal care items for future clients. The facility possesses cleaning supplies to conduct regular cleaning of the facility. These items were observed locked in a storage room next to the bathroom. LPA observed activities for clients to engage in.
The facility does not have a laundry room and does not have an outdoor area for client engagement. The hot water temperature was recorded in the bathroom sink at 105F, and the land line was observed to be operational (760 691 9622). No bodies of water or firearms are being kept in the facility.

Component III orientation was conducted during the visit with the applicants of the facility. An exit interview was conducted were this report was reviewed and provided to the applicants, Lorena Maharaj.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2023
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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