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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603509
Report Date: 03/25/2022
Date Signed: 03/25/2022 06:59:19 PM


Document Has Been Signed on 03/25/2022 06:59 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
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: 81DATE:
03/25/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Randal NetwonTIME COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced case management visit due to a request to change the facility capacity. LPA was greeted by, identified herself to, and discussed the purpose of the visit with Business Office Director Kristiana Lopez. Administrator Randal Newton arrived during the visit.

A Change of Capacity application was received by the Department on 12/31/21, in which the licensee requested a decrease in capacity from 126 to 105 residents. The Fire Safety Inspection Request was approved by the local fire authority on March 22, 2022.

During today’s visit, LPA toured the facility and observed the residents in care. The facility sketch was consistent with the current layout of the facility. No immediate health and/or safety concerns were observed.

The completed change of capacity request will be forwarded to management for final review and approval. An exit interview was conducted with Administrator Randal Newton, to whom a copy of this report and the Licensee Rights (LIC9058 01/16) were provided via email.

SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A RuizTELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:
DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022
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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