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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602824
Report Date: 10/30/2024
Date Signed: 10/30/2024 03:13:27 PM

Document Has Been Signed on 10/30/2024 03:13 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:CPSRC BMDTP-LAKESIDEFACILITY NUMBER:
374602824
ADMINISTRATOR/
DIRECTOR:		NANCY ELDRIDGEFACILITY TYPE:
775
ADDRESS:11757 TOPO LANETELEPHONE:
(619) 561-7405
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 30CENSUS: 28DATE:
10/30/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Assistant Administrator Crystal CaveTIME VISIT/
INSPECTION COMPLETED:
12:55 PM
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Licensing Program Analyst (LPA) Correia conducted an unannounced Required Annual Inspection. LPA was greeted by Assistant Administrator Cave, identified herself and discussed the purpose of the visit.


According to the facility’s license, there may be a maximum of thirty (30) clients at any given time at the day program site, all of which must be ambulatory. During today’s inspection, there were twenty-five (25) clients present at the day program site.

LPA Correia accompanied by Assistant Administrator Cave, toured the interior and exterior of the day program facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Doors, windows and screens, sinks, and toilets were in working order. Hand hygiene supplies and Personal Protective Equipment were present. The facility had sufficient space and equipment to facilitate visitation, meetings, and client activities. There is one main building with 2 classrooms, offices, and bathrooms. There is a large, covered area that they use for morning meetings and class activities. The facility’s ambient internal temperature was comfortable and compliant. Hot water temperature in the bathroom taps accessible to clients measures at 114 degrees Fahrenheit. The facility's last disaster drill was conducted on August 30, 2024. Smoke alarms were present and operational, fire hydrant was observed with current inspection, and medications and toxins were locked and inaccessible to clients.

[Continued on 809-C]

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: CPSRC BMDTP-LAKESIDE
FACILITY NUMBER: 374602824
VISIT DATE: 10/30/2024
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[Continued from LIC 9099]

No deficiencies were observed during today's visit. An exit interview was conducted with Assistant Administrator Cave and a copy of this report along with the Licensee Rights (LIC 9058 FAS 01/16) will be provided at the conclusion of the visit. Signature below confirms receipt of the reports.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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