374603572-3-6-2023-18-AS-CNWE-CPNUWP-20230306145705

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374603572
Report Date: 03/06/2023
Date Signed: 03/06/2023 02:57:12 PM

Document Has Been Signed on 03/06/2023 02:57 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	AVID BEHAVIORAL DAY PROGRAM		FACILITY NUMBER:	374603572
ADMINISTRATOR:	SARAI MARCELIN		FACILITY TYPE:	775
ADDRESS:	562 W GRAND AVENUE		TELEPHONE:	(442) 999-5740
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92025
CAPACITY: 45		CENSUS: 50	DATE:	03/06/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Sarai Marcelin, Licensee Lorena Maharaj, Licensee		TIME COMPLETED:	03:00 PM

NARRATIVE

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Licensing Program Analyst (LPA) Chinwe Nwogene conducted an unannounced case management visit to increase the capacity per licensee request. LPA met with Licensees, Sarai Marcelin and Lorena Maharaj and explained the purpose of the visit.

Licensees requested for a capacity increase from 45 to 60 clients. A Fire Clearance was approved on 2/7/2023 for 45 ambulatory and 15 non-ambulatory clients. Facility sketch on file shows sufficient square footage in the facility and activity rooms to accommodate the requested capacity. LPA Nwogene discussed the facility sketch with Licensee as well as the proposed changes to the facility capacity. LPA Nwogene and Licensee Marcelin toured the interior/exterior of the building and visually inspected the facility. LPA Nwogene confirmed facility has an exit door to the outside of the facility. LPA Nwogene additionally confirmed that there are sufficient bathrooms in the facility to meet Title 22 requirements for ratio of clients to bathrooms.

The physical plant is ready for increase in capacity. LPA will submit file for capacity increase approval. The final approval of capacity increase is contingent upon LPM's final file review. Licensee will be notified by LPA once capacity increase has been approved by licensing. If capacity increase is approved, new license will follow in the mail after phone notification by LPA with Licensee.

An exit interview was conducted where this report was discussed with and a copy was provided to Licensee, Sarai Marcelin.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Chinwe Nwogene
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

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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