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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600926
Report Date: 04/23/2024
Date Signed: 04/23/2024 03:16:00 PM


Document Has Been Signed on 04/23/2024 03:16 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:DITA RESIDENTIAL CARE FACILITYFACILITY NUMBER:
374600926
ADMINISTRATOR:BERNARDITA CABRERAFACILITY TYPE:
740
ADDRESS:303 DALEGROVE LANETELEPHONE:
(619) 267-8270
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:6CENSUS: 0DATE:
04/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Bernardita Cabrera, LicenseeTIME COMPLETED:
03:25 PM
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Licensing Program Analyst (LPA) Dawn Segura conducted a case management facility closure visit. LPA introduced herself, was granted entry into the facility, and met with Bernardita Cabrera, Licensee, to whom she disclosed the reason for the visit.

Written notification was provided to Community Care Licensing on February 28, 2024 that the facility would be closing effective April 19, 2024. Community Care Licensing was also provided copies of notification letters, dated February 19, 2024, that were provided to residents in care notifying of the facility’s closure. During today’s visit, LPA was informed that one resident relocated on April 16, 2024, and the remaining resident relocated on April 22, 2024.

During today's visit, LPA toured the facility. On this day, LPA observed that the facility location is no longer occupied by residents in care.

LPA was informed by Bernardita Cabrera, Licensee, that the property will be used only as a personal family residence at this time.

An exit interview was conducted with Bernardita Cabrera, Licensee, and a copy of this report and Licensee Rights (LIC 9058 01/16) were provided to her at the conclusion of the visit. Licensee’s signature below confirms receipt of the rights and a copy of this report.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn SeguraTELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024
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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