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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603509
Report Date: 07/24/2020
Date Signed: 07/24/2020 05:00:24 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:WESTMONT AT SAN MIGUEL RANCHFACILITY NUMBER:
374603509
ADMINISTRATOR:NEWTON, RANDALFACILITY TYPE:
740
ADDRESS:2325 PROCTOR VALLEY RDTELEPHONE:
(619) 271-4385
CITY:CHULA VISTASTATE: CAZIP CODE:
91914
CAPACITY:126CENSUS: 89DATE:
07/24/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Randal NewtonTIME COMPLETED:
10:12 AM
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Licensing Program Analyst (LPA) Kennedy conducted a case management visit via a video-calling app due to COVID-19 restrictions to follow-up on an incident of elopement received by CCL on 7-9-20. LPA identified herself and stated the purpose of the video-call to Randal Newton, Executive Director.
Resident 1 (R-1) (See LIC 811 for confidential names) is a resident receiving assisted living services from the facility. R-1 was found wandering outside their room at 3:00 AM. Facility staff returned R-1 to their room and forty-five minutes later staff checked on R-1 and found R-1 missing from their apartment. Staff checked the building and grounds and found R-1 outside on the facility grounds. R-1 was returned to the apartment and spent the rest of the night asleep. LPA reviewed documents including physician's report, narrative charting, and care plan and interviewed staff members. It was determined that R-1 has never had an incident of wandering in the year and a half they have lived at the facility and has not had an incident since. The facility staff, R-1, and R-1's responsible party have made a plan to have R-1 re-evaluated by R-1's physician, and have R-1 wear a pendant that alerts staff if R-1 exits a door.
No deficiencies were cited during this video visit.
An exit interview was conducted with Randal Newton, Executive Director. via video-call. A copy of this report along with Licensee Rights (LIC9058 01/2016) was provided to Mr. Newton via email. An electronic response confirms the documents were received.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Anna KennedyTELEPHONE: (619) 997- 4108
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2020
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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