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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603600
Report Date: 12/20/2019
Date Signed: 12/20/2019 04:01:54 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:GLEN AT SCRIPPS RANCH, THEFACILITY NUMBER:
374603600
ADMINISTRATOR:KLINE, MEEGANFACILITY TYPE:
741
ADDRESS:9800 GLEN CENTER DRIVETELEPHONE:
(858) 444-8500
CITY:SAN DIEGOSTATE: CAZIP CODE:
92131
CAPACITY:403CENSUS: 138DATE:
12/20/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Executive Director, Meegan KlineTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA), Natasha Persaud conducted a Prelicensing visit. LPA met with Executive Director, Meegan Kline, Chief Operating Officer, Darolyn Jorgensen-Kares.

Facility Profile: Facility will serve elderly residents ages 60 and above; 248 Ambulatory; 155 Non-Ambulatory, of which 6 may be bedridden on the first and second floors in any area except villas. Villas approved for Ambulatory only. Non-Ambulatory approved for all areas except villas. Hospice Waiver approved for 6.

The fire clearance was approved on 12/11/19. At this time the facility will not be serving assisted living residents, independent residents only. The construction for the assisted living portion of the facility is anticipated to be completed in less than 2 years. The facility is ready for licensure. No deficiencies were issued.

An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) was provided to Executive Director, Meegan Kline whose signature below confirms receipt of these rights.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019
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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