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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602872
Report Date: 10/13/2022
Date Signed: 10/13/2022 01:49:07 PM

Document Has Been Signed on 10/13/2022 01:49 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:BRISA DEL SOLFACILITY NUMBER:
374602872
ADMINISTRATOR:SALVADOR ANTONFACILITY TYPE:
735
ADDRESS:38133 HIGHWAY 94TELEPHONE:
(619) 746-4664
CITY:BOULEVARDSTATE: CAZIP CODE:
91905
CAPACITY: 4CENSUS: 4DATE:
10/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Staff, Alexandra CalderonTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced Required 1 - Year Visit. The LPA was greeted by Staff, Alexandra Calderon, identified himself, and discussed the purpose of the visit.

The LPA conducted a tour with Staff, Alexandra Calderon. In accordance with the Department’s Infection Control program, The LPA provided technical assistance and observed and evaluated the facility's implementation of their COVID-19 Mitigation Plan (LIC 808).

The LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy, and signs throughout the facility to promote hand hygiene, face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; and an adequate supply of PPE (Personal Protective Equipment). Based on observations, the facility is in compliance with and has implemented infection control practices as outlined in its LIC 808. No deficiencies were observed during today's visit.

An exit interview was conducted with Staff, Alexandra Calderon, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via electronic mail. An electronic mail read receipt confirms the documents were received.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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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