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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603342
Report Date: 01/21/2025
Date Signed: 01/21/2025 04:39:28 PM

Document Has Been Signed on 01/21/2025 04:39 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:NOBLE LIVINGFACILITY NUMBER:
374603342
ADMINISTRATOR/
DIRECTOR:
NORA GARCIAFACILITY TYPE:
740
ADDRESS:5211 JOAN COURTTELEPHONE:
(619) 269-8541
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
01/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Administrator, Elizabeth Gastelum.TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted and allowed entry into the facility and conducted the visit with Administrator, Elizabeth Gastelum. Administrator, Nora Garcia arrived during the visit.

LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Client bedrooms contained the required furnishings. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas.

There is a pool on the premises made inaccessible to residents. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher were present. First aid kit were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

LPA interviewed staff/clients and reviewed multiple staff and client records/files. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas.

No deficiencies were observed or cited during today's annual inspection.

An exit interview was conducted with Administrators, Elizabeth Gastelum and Nora Garcia to whom a copy of this report was provided during the visit.

Denise PowellTELEPHONE: (619) 767-2317
Amy RodgersTELEPHONE: 619-997-4108
DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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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