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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600566
Report Date: 10/04/2024
Date Signed: 10/04/2024 09:35:23 AM


Document Has Been Signed on 10/04/2024 09:35 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:REDWOOD TERRACEFACILITY NUMBER:
374600566
ADMINISTRATOR:LEIF CAMERONFACILITY TYPE:
741
ADDRESS:710 WEST 13TH AVENUETELEPHONE:
(760) 747-4306
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:210CENSUS: 163DATE:
10/04/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Administrator, Lisa Alhambra TIME COMPLETED:
09:50 AM
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Licensing Program Analyst (LPA) Kathleen Banrasavong conducted an unannounced case management visit to the facility. LPA met with Administrator, Lisa Alhambra, LPA explained the nature of the visit and was granted entry into the facility. The purpose of this visit is to conduct a verification visit at the facility to ensure that the individual has been removed.

The purpose of today's visit is to conduct a follow up visit for an Immediate Exclusion letter for staff 1 (S1). S1 was not present during today’s visit. LPA was informed by Administrator, Lisa Alhambra that S1 was termed on 08/01/2024 and has not worked at the facility since 08/01/2024. LPA requested and obtained S1's termination paperwork. LPA conducted a tour of the facility. There was no health and safety concerns at this time.

Based on evidence obtained during today's visit, the LPA has verified the individual is not present, employed or residing at the facility. LPA has advised the licensee to disassociate the individual from their roster and submit an updated LIC 500.

No deficiencies were cited during this visit. An exit interview was conducted where this report, an 811 was provided and discussed and provided to the Administrator, Lisa Alhambra.

SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen BanrasavongTELEPHONE: 951-622-3619
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2024
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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