<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374601769
Report Date: 01/10/2024
Date Signed: 01/10/2024 02:15:05 PM

Document Has Been Signed on 01/10/2024 02:15 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:FALLBROOK ADULT DAY CAREFACILITY NUMBER:
374601769
ADMINISTRATOR:OTERIA MEDLEYFACILITY TYPE:
775
ADDRESS:320 W. ALVARADOTELEPHONE:
(760) 723-0890
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 30CENSUS: 15DATE:
01/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:58 PM
MET WITH:ADMINISTRATOR, DEANNA BADGLEYTIME COMPLETED:
02:18 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
On January 10, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived to the facility unannounced in order to conduct the required annual inspection. LPA Mixson met with Administrator, Deanna Badgley introduced self, and stated the purpose of the visit. Facility file review was conducted in office and additional files and forms were reviewed on site.

LPA Mixson toured the facility, along with the Administrator, and inspected the inside and outside of the facility. The facility is a single story building located at 320 W. Alvarado Fallbrook, CA. 92028. Phone number is (760) 723-0890 and is operable. Physical Plant: The physical plant, is in good condition, neat, and orderly. Outdoor and indoor passageways are free of obstruction at the time of this visit. The day program activity rooms have the required furniture; such as tables, chairs, storage space, and sufficient lighting. The building temperatures throughout was within regulations. All activity rooms were equipped with the required items. The Administrator tested the hot water temperature in several of the restrooms, in which they each tested as required for regulations. The restrooms were equipped with liquid soap and paper towels. LPA Mixson toured the kitchen and staff were preparing snacks. The facility had activity schedules posted and available for review. The day program has emergency food and water. LPA Mixson inspected the common areas. Smoke detectors were reviewed and the all batteries were replaced in December 2023. The fire extinguisher was in the green and the program recently had fire inspection. Carbon monoxide alarms, along with smoke detectors were observed. There was a locked and centralized storage area for medications. Medications are brought in daily by residents responsible parties. The day program had a designated area for resident and staff files, and it was locked and inaccessible to residents. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There was adequate seating in the common areas and sufficient space for activities. LPA Mixson observed monthly activity calendars. LPA Mixson reviewed three staff files, five resident files, and conducted three staff interviews and five resident interviews. There were no regulation violations observed during todays visit. An exit interview was conducted and a copy of this report was provided to Administrator, Deanna Badgley.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1