374600904-12-4-2025-08-AS-MGCO-DP38G2-20251204212935

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374600904
Report Date: 12/04/2025
Date Signed: 12/04/2025 09:43:56 PM

Document Has Been Signed on 12/04/2025 09:43 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 RESIDENTIAL		FACILITY NUMBER:	374600904
ADMINISTRATOR/ DIRECTOR:	LARA, OSCAR		FACILITY TYPE:	735
ADDRESS:	2840 VIA DEL ALLAZON		TELEPHONE:	(619) 267-4955
CITY:	BONITA	STATE: CA	ZIP CODE:	91902
CAPACITY: 4		CENSUS: 3	DATE:	12/04/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:20 PM
MET WITH:	Administrator, Oscar Lara		TIME VISIT/ INSPECTION COMPLETED:	04:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. Upon arrival, LPA was greeted by and identified herself to Licensee Oscar Lara, and explained the purpose of the visit. According to the facility license, the maximum capacity is four (4) ambulatory clients. During today’s inspection, there were three (3) clients in care; two were present in the facility and one was attending day program. LPA, accompanied by the licensee, toured the interior and exterior of the facility. The facility was observed to be clean, sanitary, and in good repair. Pathways were free of obstructions and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were operational. Adequate hygiene supplies, linens, and Personal Protective Equipment were available. The facility had sufficient space and equipment for dining, laundry, visitation, meetings, and client activities. Hot water temperature at client accessible taps measured 110°F. The indoor room temperature measured 72°F, within regulatory requirements. Food supplies included at least two (2) days of perishable food and at least seven (7) days of non-perishable food, all properly stored. Cooking and dining equipment were present. Toxic substances were secured and inaccessible to clients. Medications were properly labeled and stored in locked areas. (continue at LIC809C)

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: 12/04/2025

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(continue from LIC809)

The facility has an empty pool on the premises; LPA observed the pool area to be gated and locked. The licensee stated that no firearms or ammunition are kept on the property. Smoke detectors, carbon monoxide detectors, emergency lighting, and the facility telephone were tested and are functioning properly.

Fire extinguishers were last serviced in December 2025. First aid kits were stocked and readily accessible. Required licensing postings were displayed in visible areas. LPA confirmed that the licensee maintains current liability insurance and an active surety bond. The most recent emergency drill was conducted on October 17, 2025, at 7:00 p.m. with all clients present. Staff files contained current first aid certifications dated October 21, 2026.

LPA interviewed staff and reviewed multiple staff and client records. All records reviewed contained the required documentation and were stored in locked, confidential areas.

No deficiencies were cited during today’s annual inspection.

An exit interview was conducted with Oscar Lara, to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058, 03/22) were provided.

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC809 (FAS) - (06/04)

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