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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603572
Report Date: 04/27/2023
Date Signed: 04/27/2023 01:07:56 PM

Document Has Been Signed on 04/27/2023 01:07 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 PROGRAMFACILITY NUMBER:
374603572
ADMINISTRATOR:SARAI MARCELINFACILITY TYPE:
775
ADDRESS:562 W GRAND AVENUETELEPHONE:
(442) 999-5740
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY: 60CENSUS: 58DATE:
04/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:ADMINISTRATOR, SARAI MARCELINTIME COMPLETED:
01:20 PM
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On April 27, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived to the facility unannounced in order to conduct the required annual inspection. LPA Mixson met with Administrator, introduced self, and stated the purpose of the visit. LPA Mixson toured the facility, along with the Administrator, and inspected the inside and outside of the facility. The facility is a single story building located at 562 W. Grand AVE, in Escondido, CA.
Physical Plant: The physical plant, is in good condition, neat, and orderly. Outdoor and indoor passageways are free of obstruction at the time of this visit. The day program activity rooms have the required furniture; such as tables, chairs, storage space, and sufficient lighting. The building temperatures throughout was comfortable. All activity rooms were equipped with the required items. The Administrator tested the hot water temperature in several of the restrooms, in which they each tested as required for regulations. The restrooms were equipped with liquid soap and paper towels. LPA Mixson toured the kitchen and staff were preparing lunch. The facility had activity schedules posted and available for review. The day program has emergency food and water. LPA Mixson inspected the common areas. Smoke detectors are hard wired and were tested. The fire extinguisher was in the green and the program recently had fire inspection. Carbon monoxide alarms, along with smoke detectors were observed. There was a locked and centralized storage area for medications. Medications are contained in bubble packs. The day program had a designated area for resident and staff files, and it was lockable. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There was adequate seating in the common areas and sufficient space for activities. LPA Mixson observed monthly activity calendars. LPA Mixson reviewed six staff files, five resident files, and conducted three staff interviews and three resident interviews. There were no regulation violations observed during todays visit.
An exit interview was conducted and a copy of this report, along with the LIC 811, was provided to Administrator.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2023
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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