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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603600
Report Date: 03/11/2020
Date Signed: 03/12/2020 07:58:11 AM

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: 198DATE:
03/11/2020
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Executive Director, Meegan Kline,TIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA), Natasha Persaud conducted a Post Licensing visit. LPA met with Executive Director, Meegan Kline, and discussed the purpose of the visit, to inspect the facility to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 6.

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. LPA discussed bodies of water and inaccessibility of heating sources to include the fire pits and cooking grills. According to the Executive Director, only independent residents will have access to bodies of water and heating sources.

During today's inspection LPA observed the following: All indoor and outdoor passageways were free from obstructions; According to the Executive Director there are no firearms on the premises; Hot water temperature used by residents measured between 111-120 degrees Fahrenheit; Facility has a full functioning kitchen that met statutory requirements; All resident room have a smoke detector with an integrated carbon monoxide detector.

LPA reviewed some staff records and verified that staff have the required Criminal Record Statement, Personnel Record, TB clearance, and Health Screening Report in their file. LPA reviewed resident records and verified that the Physician's Reports, Resident Appraisals, Identification and Emergency Information, and Admission Agreements were in each resident's file.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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, THE
FACILITY NUMBER: 374603600
VISIT DATE: 03/11/2020
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Based on today's inspection, no deficiencies were observed in the area evaluated. 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: 03/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020
LIC809 (FAS) - (06/04)
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