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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 371881461
Report Date: 06/07/2024
Date Signed: 06/07/2024 01:38:14 PM

Document Has Been Signed on 06/07/2024 01:38 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
Lookup Error,
, CA
FACILITY NAME:CENTER FOR THE ARTS AND ADULT EDUCATION, THEFACILITY NUMBER:
371881461
ADMINISTRATOR/
DIRECTOR:		HERENDEEN, CYNTHIAFACILITY TYPE:
775
ADDRESS:555 DEER SPRING ROADTELEPHONE:
(760) 721-1706
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 200CENSUS: DATE:
06/07/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Cyndi Herendeen, Director of Adult Day Services TIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA), Amy Rodgers, conducted an unannounced collateral visit as a follow-up for an unrelated complaint investigation for another facility. LPA was allowed entry by Cyndi Herendeen, Director of Adult Day Services and discussed the purpose of the visit.

During the visit, LPA conducted interviews with staff and observed clients.

An exit interview was conducted with Cyndi Herendeen, Director of Adult Day Services and copy of this report along with Licensee Rights was provided to Cyndi Herendeen, Director of Adult Day Services whose signature below verifies receipt of these rights.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024
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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