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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603533
Report Date: 08/18/2023
Date Signed: 08/18/2023 04:55:57 PM

Document Has Been Signed on 08/18/2023 04:55 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:WORK SKILL RESOURCESFACILITY NUMBER:
374603533
ADMINISTRATOR:ENUNWA, EBELEFACILITY TYPE:
775
ADDRESS:9349 JAMACHA BLVDTELEPHONE:
(619) 512-1107
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 60CENSUS: 50DATE:
08/18/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Licensee Emeka EnunwaTIME COMPLETED:
05:00 PM
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Licensing Program Analysts (LPA) Dang Nguyen and Amy Rodgers conducted an unannounced Case Management - Incident visit. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Licensee Emeka Enunwa.

Today's visit was in response to an LIC624 Incident Report, which licensee self-submitted to the CCLD San Diego Regional Office (received on 08/10/2023). The LIC624 described a physical altercation between Client #1 (C1) and Client #2 (C2) on 08/09/2023. [See LIC 811 Confidential Names List for a description of person identifiers used in this report].

During today’s visit, LPAs performed a facility tour, collected pertinent records, and interviewed relevant staff. At the time of the visit, C1 and C2 were both not at the day program site.

Records and staff interviews showed: During the above incident, day program staff timely intervened to separate C1 and C2. Neither client suffered any injury beyond superficial skin redness. The day program has since kept C1 and C2 further apart from each other, and each client has a respective care plan describing behavioral interventions to help them manage frustration and anger.

No deficiencies were cited for the above incident. Also, no deficiencies were observed or cited during today’s visit. However, LPAs issued Technical Violations regarding Absentee Notification Plan and Reporting Requirements (see the LIC 9102-TV pages).

An exit interview was conducted with Enunwa, to whom a copy of this report, the LIC9102-TV pages, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 08/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2023
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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