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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602424
Report Date: 12/07/2023
Date Signed: 12/07/2023 01:41:29 PM

Document Has Been Signed on 12/07/2023 01:41 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:HOME OF GUIDING HANDS-PROSPECT HOUSEFACILITY NUMBER:
374602424
ADMINISTRATOR:RENE M. DOEHRERFACILITY TYPE:
735
ADDRESS:9643 PROSPECT AVETELEPHONE:
(619) 328-6248
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 6CENSUS: 4DATE:
12/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Residential Service Technician Larry BennettTIME COMPLETED:
01:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management Visit to observe the physical plant. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Residential Service Technician Larry Bennett.

On 09/25/2023, the Licensee submitted an LIC200 Application to the CCLD San Diego Regional Office (RO) requesting to decrease the facility's total licensed capacity from six (6) clients down to four (4) clients.

On 10/24/2023, the local fire authority approved/granted an updated fire clearance, reflecting the facility was approved for four (4) clients in total, of which all must be ambulatory. The fire authority also approved the facility's updated floor plan.



During today’s visit, LPA briefly toured the interior and exterior of the facility. The updated facility sketch/floor plan was consistent with the current layout of the facility.

No deficiencies were observed or cited during today's visit.

This portion of the application process has been completed. The Licensee will be sent an updated license to reflect the new fire clearance after CCLD management’s final review and approval.

An exit interview was conducted with Bennett. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided to the licensee during the visit.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2023
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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