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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602984
Report Date: 03/10/2023
Date Signed: 03/10/2023 12:09:44 PM

Document Has Been Signed on 03/10/2023 12:09 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: 4DATE:
03/10/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Administrator Rene Doehrer and Assistant Vice President of Residential Services (AVPRS) Fred Lindahl.TIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Debbie Correia conducted an announced Case Management visit. LPA was met by Administrator Doehrer and Assistant Vice President of Residential Services (AVPRS) Lindahl and was granted entry into the facility. LPA discussed the purpose of the visit upon facility entry.

A Change of Capacity application was received by Community Care Licensing (CCL) on January 24, 2023, in which the Licensee requested a decrease in capacity from six (6) to four (4) clients. The Fire Safety Inspection Request, dated January 27, 2023, was approved by the local fire authority on February 13, 2023. The approval was received by Community Care Licensing on the following day, February 14, 2023.

During today's visit LPA, accompanied by Administrator Doehrer and AVPRS Lindahl, conducted a tour of the facility. During the tour, LPA observed no immediate health or safety concerns. LPA observed the facility sketch/floor plan to be consistent with the current layout and accommodations at the facility.

The completed change of capacity request will be forwarded to management for final review and approval. Approval notification to the Licensee will be made by Community Care Licensing, and a new license will be mailed to the Licensee after final approval.

This report was discussed with Administrator Doehrer and AVPRS Lindahl. A copy of this report (LIC 809) was provided to Administrator Doehrer at the conclusion of the visit.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2023
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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