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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600904
Report Date: 12/16/2024
Date Signed: 12/16/2024 06:10:47 PM

Document Has Been Signed on 12/16/2024 06:10 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:L & M RESIDENTIALFACILITY NUMBER:
374600904
ADMINISTRATOR/
DIRECTOR:
LARA, OSCARFACILITY TYPE:
735
ADDRESS:2840 VIA DEL ALLAZONTELEPHONE:
(619) 267-4955
CITY:BONITASTATE: CAZIP CODE:
91902
CAPACITY: 4CENSUS: 3DATE:
12/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:20 PM
MET WITH:Administrator, Oscar LaraTIME VISIT/
INSPECTION COMPLETED:
05:10 PM
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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with licensee Oscar Lara.

The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with licensee Oscar Lara. According to the facility’s license, the facility has a maximum capacity of four (4) clients, of which all must be ambulatory During today’s inspection there were three (3) clients in care, of which two were present in the facility. One client was at day program.

LPA, accompanied by licensee, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment.



The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Hot water temperature at taps accessible to clients was at 106 F degrees. The room temperature at the facility was 68 F degrees within regulation.

There were at least 2 days of perishable food, and at least 7 days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required and stored in locked areas.

Facility has an empty pool on the premises. LPA observed the pool was gated and locked. Per the licensee, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. (continue at LIC809C)
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: L & M RESIDENTIAL
FACILITY NUMBER: 374600904
VISIT DATE: 12/16/2024
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(continue from LIC809)

Fire extinguisher(s) were serviced within the last 12 months, September 26, 2024. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed and confirmed Licensee had current liability insurance and the surety bond was current. Facility staff conducted the emergency drill on November 25, 2024 at 6:30 p.m. with all the clients present. Staff had current fist aid certificates on file.

LPA interviewed staff and reviewed multiple staff and client records/files. The files that LPA reviewed contained the required documents. Confidential records were stored in a locked area.

No deficiencies were cited during today's annual inspection.

An exit interview was conducted with Lara to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC809 (FAS) - (06/04)
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