<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 371881409
Report Date: 10/27/2023
Date Signed: 10/27/2023 01:15:01 PM

Document Has Been Signed on 10/27/2023 01:15 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:AVID BEHAVIORAL DAY PROGRAM-CAPALINAFACILITY NUMBER:
371881409
ADMINISTRATOR:MARCELIN, SARAIFACILITY TYPE:
775
ADDRESS:1637 CAPALINA RDTELEPHONE:
(858) 442-6840
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 120CENSUS: 0DATE:
10/27/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:28 AM
MET WITH:Sarai Marcelin, Licensee TIME COMPLETED:
01:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/27/2023, Licensing Program Analyst (LPA), Chinwe Nwogene conducted an announced pre-licensing inspection at the facility. LPA Nwogene met with Applicant, Sarai Marcelin and toured the facility.

Application: The application is for Adult Day Program. The fire clearance has been granted for (100) Ambulatory and (20) non-ambulatory clients. The Day Program is located on the first floor of a two-level building.

During today's visit, LPA toured the facility and inspected every room. The facility was found to be clean and in good repair with no pathway obstruction. Clients' bathrooms were observed to be clean, and the toilets were found to be working order. The facility's water temperature measured at 105 degrees Fahrenheit. LPA observed a closet were all hazard and/or toxic material will be stored and secured. There is also a secure medication room for medication storage. Fire Extinguishers were inspected and found to be in compliance. There are no bodies of water observed near and/or on the premises. The facility does not have firearm and/or ammunition on grounds. There were sufficient amount of 7 day non-perishable snack items observed. However, there no 2 day perishable food supply observed as clients have not been admitted to the facility yet. All required postings, including COVID’s postings, were posted near the entryway and throughout the facility. LPA observed some work being done in the backyard.

Missing Items:

  • Window Screen
  • Backyard in good condition

LPA Nwogene will inform the Centralized Applications Bureau (CAB) that the facility is ready for licensure once proof of the missing items has been received.

An exit interview was conducted were this report was discussed with and provided to Sarai Marcelin.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Chinwe Nwogene
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1