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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600289
Report Date: 07/06/2022
Date Signed: 07/06/2022 02:03:12 PM


Document Has Been Signed on 07/06/2022 02:03 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:LEMON GROVE TERRACEFACILITY NUMBER:
374600289
ADMINISTRATOR:CELIA A. MENESESFACILITY TYPE:
740
ADDRESS:8554 CALLE NORTETELEPHONE:
(619) 463-6705
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:6CENSUS: 5DATE:
07/06/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Administrator Celia MenesesTIME COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA), Kayla Hilario, and County of San Diego Nurse Contractor, Elizar Perez, conducted an on-site visit. LPA and Nurse identified themselves and discussed the purpose of the visit with Administrator Celia Meneses.

The Department conducted the on-site visit to provide technical assistance and to evaluate the facility's disinfection, screening protocols as well as the use of personal protective equipment. During today's visit, Celia Meneses, was interviewed and a walk-though of the facility was conducted. A debriefing was conducted with Celia Meneses at the conclusion of the visit. No deficiencies were observed or issued today.

An exit interview was conducted with Administrator Celia Meneses and a copy of this report, along with Licensee Rights (LIC 9058 01/16), were provided to the Administrator via hardcopy at the conclusion of the visit.
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Kayla HilarioTELEPHONE: 619-481-0844
LICENSING EVALUATOR SIGNATURE:
DATE: 07/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/06/2022
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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