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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603253
Report Date: 11/02/2021
Date Signed: 11/03/2021 10:26:53 AM

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:LANTERN CRESTFACILITY NUMBER:
374603253
ADMINISTRATOR:DIANA SANTANAFACILITY TYPE:
740
ADDRESS:800 LANTERN CREST WAYTELEPHONE:
(619) 258-8886
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:100CENSUS: 78DATE:
11/02/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
06:16 PM
MET WITH:Receptionist, Marylou GloverTIME COMPLETED:
06:35 PM
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Licensing Program Analyst (LPA) Debbie Correia, conducted an unannounced Case Management-Incident visit. LPA was greeted at the door by Receptionist Glover, granted entry after identifying herself and disclosing the purpose of her visit.

The purpose of LPA’s visit was to discuss an incident report which was received in our office on October 28, 2021. Incident report indicates client #1 left the facility (AWOL'd) on October 21,2021. LPA Correia conducted a record request however an interview with Administrator Diana Santana, revealed facility staff never lost site of C1. C1 went directly out front of the building to look at the sky, and then was redirected back into the facility. C1 is allowed to leave the facility unassisted and does not suffer form memory or cognitive impairment.

No deficiency cited. An exit interview was conducted, this report was discussed and a copy of the report was provided via email to Administrator Santana along with Licensee Rights (LIC 9058 01/16). AN electronic email read reply confirms receipt of the report.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Debbie CorreiaTELEPHONE: (619) 407-0894
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021
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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