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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603565
Report Date: 07/23/2020
Date Signed: 07/23/2020 04:19:13 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:LA VIDA REALFACILITY NUMBER:
374603565
ADMINISTRATOR:LITTLEFIELD, RUELFACILITY TYPE:
740
ADDRESS:11588 VIA RANCHO SAN DIEGOTELEPHONE:
(619) 660-5778
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:177CENSUS: 94DATE:
07/23/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:17 PM
MET WITH:Kim GarciaTIME COMPLETED:
04:18 PM
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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 confirm that Individual 1 (I-1) (see LIC 811 for confidential names) is not employed at the facility and is not on the facility grounds. LPA identified herself and stated the purpose of the video-call to Kim Garcia, Assistant Executive Director.

I-1 worked at the facility from 4/10/2020-4/29/2020 as a server in the dining room serving residents. I-1's employment ended due to notification that they did not pass background and was removed form the facility.

LPA interviewed current staff members who reported that I-1 has not been on the property for several months. LPA reviewed staff schedules for the previous week and confirmed the I-1 was not scheduled to work. LPA was satisfied the I-1 was not employed or been on the facility grounds since 4-29-20.

No deficiencies were observed or cited during the tele-visit.

An exit interview was conducted with Kim Garcia, Assistant Executive Director. via video-call. A copy of this report along with Licensee Rights (LIC9058 01/2016) was provided to Ms. Garcia 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: 07/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2020
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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