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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374601632
Report Date: 02/29/2024
Date Signed: 02/29/2024 01:33:50 PM


Document Has Been Signed on 02/29/2024 01:33 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:OPALEC HOME CAREFACILITY NUMBER:
374601632
ADMINISTRATOR:COX, LEANNEFACILITY TYPE:
740
ADDRESS:116 LAUSANNE DRIVETELEPHONE:
(619) 262-7172
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:6CENSUS: 6DATE:
02/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Licensee Lilia Opalec, Caregiver Angelica MirandaTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA identified himself, and discussed the purpose of the visit with Caregiver Angelica Miranda. Licensee Lilia Opalec and Administrator Desiree Arenas arrived during the visit and assisted the LPA. The facility was licensed for a capacity of Six (6), all of whom may be Non-Ambulatory. The facility was also approved for a hospice waiver of one (1).

The LPA, accompanied by the 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. . The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present. No bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. A carbon monoxide detector, facility telephone, and fire extinguisher were present. Required licensing postings were observed in a visible area of the facility.

The LPA interviewed staff and reviewed multiple staff and client records/files. Medications and cleaning solutions were locked and stored separately. No deficiencies were cited on today's visit, and technical assistance was provided to the Administrator.

An exit interview was conducted with Administrator Arenas, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were provided.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024
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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