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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602050
Report Date: 08/23/2023
Date Signed: 08/23/2023 12:25:46 PM

Document Has Been Signed on 08/23/2023 12:25 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
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:INDEPENDENT OPTIONS/ADVANCED OPTIONS SAN DIEGOFACILITY NUMBER:
374602050
ADMINISTRATOR:LISA STEVENSONFACILITY TYPE:
775
ADDRESS:302 ENTERPRISE ST SUITE CTELEPHONE:
(760) 743-7193
CITY:ESCONDIDOSTATE: CAZIP CODE:
92029
CAPACITY: 36CENSUS: 26DATE:
08/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Sandra Navarro - Assistant DirectorTIME COMPLETED:
12:35 PM
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Licensing Program Analyst (LPA) Sara Martinez arrived unannounced at the facility to conduct a case management visit to address the one (1) Special Incident Report (SIR) and a Adult Protective Service (APS) equivalent of a SOC 341 regarding an incident with Client One (C1) and Staff One (S1) on 08/17/2023. LPA was granted entry and met with assistant director Sandra Navarro, who was informed of the purpose of the visit. LPA later spoke with Regional Director Lisa Stevens on the phone regarding the incident.

The Department received one (1) SIR and SOC 341 on 08/21/2023 regarding S1's inappropriate CPI handling to redirect C1. SIR details that S1 grabbed C1 rear neck to redirect C1 to a classroom. Sandra informed LPA that in-service training (Rational Detachment, Positive Communication, and Mandated Reporting) was being implemented and was conducted on 08/22/2023 and will continue until all staff are re-trained. Lisa Stevens stated that S1 was suspended on 08/17/2023 and S1's suspension will continue until the company's investigation concludes.

LPA conducted a tour of the facility, interviews, and collected pertinent documents.

Based on observation, interviews, and record review from today’s visit, no information was received by the LPA to indicate there was any lack of care and/or supervision. The facility took immediate action to correct the incident. No citations have been issued at this time.

An exit interview was conducted and a copy of this report along with LIC811, was provided to Assistant Director Sandra Navarro.

SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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