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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602984
Report Date: 05/20/2022
Date Signed: 05/23/2022 12:16:13 PM

Document Has Been Signed on 05/23/2022 12:16 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-CALDERAFACILITY NUMBER:
374602984
ADMINISTRATOR:RENE DOEHRERFACILITY TYPE:
735
ADDRESS:9915 VIA RITATELEPHONE:
(619) 596-2067
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: 6CENSUS: 5DATE:
05/20/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Administrator Rene DoehrerTIME COMPLETED:
10:55 AM
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Licensing Program Analyst, Debbie Correia and the County of San Diego Nurse, Sandra Brackman, with the HAI Program, conducted an on-site visit. The team identified themselves and discussed the purpose of the visit with Administrator Rene Doehrer.

The Department and HAI Team conducted the on-site visit to provide technical assistance and to evaluate the facility's disinfection, testing surveillance, screening protocols as well as the use of personal protective equipment. During today's visit, the team conducted a walk-through of the facility. A debriefing was conducted with Administrator Doehrer at the conclusion of the visit. During today's visit, no deficiencies were issued.

An exit interview was conducted with Administrator Doehrer and a copy of the Report (LIC 809) and Licensee Rights (LIC 9058 01-2016) was provided to Administrator Doehrer and signature on this report acknowledges receipt of the reports.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2022
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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