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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603274
Report Date: 08/16/2021
Date Signed: 08/16/2021 11:20:52 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:MERRILL GARDENS AT BANKERS HILLFACILITY NUMBER:
374603274
ADMINISTRATOR:LORI HANSENFACILITY TYPE:
740
ADDRESS:2567 2ND AVETELEPHONE:
(619) 209-5216
CITY:SAN DIEGOSTATE: CAZIP CODE:
92103
CAPACITY:100CENSUS: 85DATE:
08/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:48 AM
MET WITH:Resident Care Director Kelly BiondoTIME COMPLETED:
11:16 AM
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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced case management visit to conduct a health and safety check and review COVID-19 mitigation strategies. The virtual visit was conducted via FaceTime due to COVID-19 restrictions. LPA met with Resident Care Director Kelly Biondo, identified herself, and stated the purpose of the virtual visit.

During today's visit, LPA toured the facility and interviewed Resident Care Director Kelly Biondo. No deficiencies were issued during this visit.

An exit interview was conducted. A copy of this report and Licensee's Rights (9058 01/16) were provided to the Resident Care Director Kelly Biondo via electronic mail. An email receipt confirms the acknowledgement of these documents.
SUPERVISOR'S NAME: Alexandre VoTELEPHONE: (619) 385-7506
LICENSING EVALUATOR NAME: Rebecca A RuizTELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021
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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