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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603102
Report Date: 03/22/2022
Date Signed: 03/23/2022 12:02:58 AM


Document Has Been Signed on 03/23/2022 12:02 AM - 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:CARE PLUS MANSIONFACILITY NUMBER:
374603102
ADMINISTRATOR:AROMIN, GARY D.FACILITY TYPE:
740
ADDRESS:2579 WINDMILL VIEW ROADTELEPHONE:
(619) 749-1202
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:6CENSUS: 6DATE:
03/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:45 PM
MET WITH:Licensee Gary AromaTIME COMPLETED:
05:45 PM
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Licensing Program Analyst (LPA) Debbie Correia visited the facility to conduct an annual required licensing inspection. LPA Correia was met by Licensee Gary Aroma, identified herself, and was granted entry into the facility.

During today's visit, LPA Correia, accompanied by Licensee Aroma, toured the facility and verified compliance with infection control practices. LPA Correia and Licensee Aroma reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report. LPA Correia observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, clients and visitors; a sign-in policy enacted for all visitors; signs posted throughout the facility to promote hand hygiene, cough/sneeze etiquette; face coverings worn by staff; hand sanitizer/hand washing stations readily available; emergency agencies’ contact information posted in a location visible to staff and clients; and an adequate supply of cleaning products and PPE.

No deficiencies were cited during today’s visit. An exit interview was conducted with Licensee Aroma, and a copy of this report, along with the Licensee Rights (LIC 9058 FAS 01/16) were provided to him via email. An electronic receipt confirms receipt of the documents.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Debbie CorreiaTELEPHONE: (619) 407-0894
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2022
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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