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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602608
Report Date: 04/05/2024
Date Signed: 04/05/2024 12:18:09 PM

Document Has Been Signed on 04/05/2024 12:18 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 ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:SAILS ALEXANDERFACILITY NUMBER:
374602608
ADMINISTRATOR/
DIRECTOR:		LAUREN REPICIFACILITY TYPE:
735
ADDRESS:301 JOHAH RDTELEPHONE:
(760) 233-4036
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 4CENSUS: 4DATE:
04/05/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Maribel Robledo, Administrator TIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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Licensing Program Analyst (LPA) Javina George conducted a case management health check visit on the date and time note above. As LPA conducted a walk thru of the interior and exterior of the facility and observed for the door to the master bedroom to not have a door knob. LPA also observed for the door leading out to the garage to be hanging off by wires.

LPA was provided with an invoice for a maintenance request dated 2/16/24, noting that the facility is in the process of getting the necessary repairs completed for the building. It was confirmed that the repairs will be completed on 4/9/24. A citation was not issued as the maintenance request were submitted.

The facility was observed to be clean, clutter free and have a 2 day supply of perishable and 7 day supply of non perishable food items. The facility was observed to have operable utilities (water, gas. electric).

LPA discussed the necessary paperwork need to process the change of administrator. It was agreed that the paperwork will be submitted to the regional office no later than 5pm on 4/19/24.

Based on today's visit no or health and safety concerns were observed.


An exit interview was conducted and a copy of this report was provided to Maribel Robledo, Administrator.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2024
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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