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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600546
Report Date: 07/03/2024
Date Signed: 07/04/2024 06:30:33 PM

Document Has Been Signed on 07/04/2024 06:30 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:CAL-CRIS LODGEFACILITY NUMBER:
374600546
ADMINISTRATOR/
DIRECTOR:		GLADYS BELTRANFACILITY TYPE:
735
ADDRESS:8944 EMERALD GROVE AVENUETELEPHONE:
(619) 390-8501
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 10CENSUS: 9DATE:
07/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:35 PM
MET WITH:Caregiver Julita RenojoTIME VISIT/
INSPECTION COMPLETED:
04:22 PM
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Licensing Program Analyst (LPA) Debbie Correia conducted a case management visit to follow up on a 30-Day eviction notice for Client 1 (C1) submitted to the Department on June 4, 2024. LPA was greeted by Caregiver Renojo, introduced herself, and disclosed the purpose of the visit.

During the visit, the LPA (See LIC 811 for confidential names) interviewed and discussed the required circumstances to constitute a lawful eviction, as well as the required language included in an eviction notice per Title 22 California Code of Regulations. LPA informed Caregiver Renojo that C1's Notice of Eviction did not meet Title 22 required criteria therefore was not valid. No deficiencies were cited during the visit.

An exit interview was conducted with Caregiver Renojo, to whom a copy of this report and the Licensee Rights (LIC9058) will be provided at the conclusion of the visit. Signature below confirms receipt of the reports.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/03/2024
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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