<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603156
Report Date: 05/21/2021
Date Signed: 05/21/2021 02:07:09 PM

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:SENIOR CARE & COMFORT LIVINGFACILITY NUMBER:
374603156
ADMINISTRATOR:LOGALLA, BRANDONFACILITY TYPE:
740
ADDRESS:1019 GREENFIELD DRIVETELEPHONE:
(619) 334-3775
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:6CENSUS: 5DATE:
05/21/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Licensee Brandon LogallaTIME COMPLETED:
02:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Manager (LPM) John Rante, and Licensing Program Analyst (LPA) Dan Nguyen, conducted a Case Management Visit during an unannounced Complaint Visit. LPM and LPA met with Caregivers Winifreda Durango and Licensee Brandon Logalla, and we discussed the purpose of the visit.

The following deficiencies were as observed:

Upon arrival, the northern egress and one western egress route, was observed padlocked.

In addition, LPM and LPA were not appropriately screened in accordance with Departmental policies regarding COVID-19.

This deficiencies are cited in accordance to the California Code of Regulations, Title 22, Division 6, Chapter 8, and is noted on the attached LIC809-D.

An exit interview was conducted with the Licensee. A copy of this report, along with a copy of his appeal rights (LIC9058 01/16) was sent via email with an electronic read receipt, as confirmation of receipt of document
SUPERVISOR'S NAME: Icela EstradaTELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SENIOR CARE & COMFORT LIVING
FACILITY NUMBER: 374603156
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/28/2021
Section Cited

1
2
3
4
5
6
7
87307(d)(6) Personal Accommodations and Services. The following space and safety provisions shall apply to all facilities: All outdoor and indoor passageways and stairways shall be kept free of obstruction. This requirement was not met as evidenced by: Based on LPM and LPA observations, the two
8
9
10
11
12
13
14
of the four egress routes from the facility were secured with a padlock. This poses a potential health and safety risk to the residents in care.
8
9
10
11
12
13
14
Type B
05/28/2021
Section Cited

1
2
3
4
5
6
7
87468.1(a)(2) Personal Rights of Residents in All Facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Upon arrival, LPM and LPA were not appropriately screened, nor does the facility have screening procedures in place. This poses a potential health and safety risk to the residents in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Icela EstradaTELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:
DATE: 05/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2