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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 371881387
Report Date: 02/14/2023
Date Signed: 02/14/2023 11:18:34 AM

Document Has Been Signed on 02/14/2023 11:18 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:SANCHEZ RESIDENTIAL CARE 2FACILITY NUMBER:
371881387
ADMINISTRATOR:SANCHEZ, ISABELFACILITY TYPE:
735
ADDRESS:13284 JACARANDA BLOSSOM DRIVETELEPHONE:
(858) 335-3540
CITY:VALLEY CENTERSTATE: CAZIP CODE:
92082
CAPACITY: 4CENSUS: 0DATE:
02/14/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:28 AM
MET WITH:ADMINISTRATOR, ISABEL SANCHEZ.TIME COMPLETED:
11:28 AM
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On February 14, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived for a scheduled visit for the purpose of conducting a pre-licensing inspection. LPA Mixson met with Administrator, introduced herself, and stated the purpose of the visit. LPA Mixson toured the home inside and outside. The location is a two story home with six bedrooms, five bathrooms, a living room, dinning room, activity room, family room, kitchen, and three car garage with backyard, front yard, and a side yard. On 11/21/2022, The Valley Center Fire Protection District approved this location for four- ambulatory, zero non-ambulatory, and zero bedridden residents. LPA Mixson observed where medications will be stored and locked. The home is equipped with lights in the passages, and stocked with emergency night lights throughout the home. The smoke and carbon monoxide detectors were tested and are operable. LPA Mixson observed two fire extinguisher one up stairs and one down stairs, both charged and in the green. LPA Mixson observed cleaning supplies locked and inaccessible. The sharp objects are locked in a kitchen drawer, plenty of pots, pans and other kitchen accessories. All doors, and passageways are clear from obstruction. There were no bodies of water. Both fire places were covered with screen. LPA Mixson observed beds have the required linen and supplies. There was enough extra clean linen and hygiene items. There was appropriate lighting in each room with night stand, dresser and chair. LPA Mixson observed central heating and air conditioning systems. The Administrator dialed the land line phone number (760) 297-3065 and as a result of the storm like weather it was temporally not operable. Administrator called phone company (Stream Mediacom), they will send repair person. Outside/Yards: No obstructions observed. Component III reviewed. An exit interview was conducted, a copy of this report was provided to Administrator.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2023
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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