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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603360
Report Date: 03/07/2025
Date Signed: 03/07/2025 01:37:38 PM

Document Has Been Signed on 03/07/2025 01:37 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:CREST CAREFACILITY NUMBER:
374603360
ADMINISTRATOR/
DIRECTOR:		KATHERINE DOWDENFACILITY TYPE:
735
ADDRESS:3916 LIMBER PINE ROADTELEPHONE:
(760) 731-2220
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 4CENSUS: 4DATE:
03/07/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Administrator, Katherine DowdenTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On 3/7/2025, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to conduct a required annual inspection. LPA was greeted and granted entry by Administrator, Katherine Dowden who was informed of the purpose of the visit. The facility has a fire clearance for four (4) non-ambulatory clients of which one (1) may be bedridden. During the visit, there was one (1) client and three (3) caregivers present.

LPA toured the facility with Administrator Dowden. LPA observed the facility is made up of three (3) client bedrooms and two (2) client bathrooms along with a kitchen, dining room, living room, and attached garage. The facility has a gated in-ground pool located in the backyard that is secured with a digital keypad lock. Indoor and outdoor passageways are free of obstruction. Outdoor shaded seating is available for clients in care. LPA toured the kitchen and observed the facility has more than a two-day supply of perishable foods and seven-day supply of non-perishable foods. Disinfectants/cleaning solutions, medications, and sharps/knives are stored in different locked kitchen cabinets. Administrator tested one (1) of the smoke alarms and carbon monoxide detectors and LPA observed it to be operational. LPA also observed charged fire extinguishers mounted throughout the facility. LPA was informed the facility does not manage Client 1's (C1's) cash resources as C1's responsible person oversees C1's finances. LPA reviewed the Record of Client's/Resident's Safeguarded Cash Resources (LIC 405) for the remaining three (3) clients while Administrator Dowden reviewed their physical monies and no discrepancies were discovered. LPA toured the garage and observed an emergency supply of food and water along with a generator. Client files reviewed had updated Individual Program Plans and signed admission agreements. Staff present have a criminal record clearance and a valid first aid/CPR certification. LPA reviewed the facility's Emergency and Disaster Drill Record which noted their last fire drill was conducted on 2/21/2025. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Administrator Dowden.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2025
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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