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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603600
Report Date: 05/08/2020
Date Signed: 05/08/2020 10:08:59 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: 290DATE:
05/08/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Executive Director, Meegan KlineTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA), Natasha Persaud, contacted the facility via telephone regarding a Criminal Record Exemption. The visit is being conducted via telephone due to COVID-19. LPA identified herself and explained the purpose of the call to Executive Director, Meegan Kline.

During the call, visual conference with the Executive Director, LPA explained Staff #1(S1) requires a Criminal Record Exemption. Executive Director verified that S1 was not on site.

Per interview, S1 was hired on 12/17/19 and terminated on 12/27/19. The facility is pursuing an exemption request for S1. Executive Director is aware S1 is not allowed on the premises and may not return prior to an approved exemption.

An exit interview was conducted via telephone, and a copy of this report and Licensee's Rights (9058 01/16) were e-mailed to the Executive Director. An e-mail read receipt confirms the acceptance of these documents. [See LIC 811 Confidential Names List to identify Staff #1]
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2020
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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