<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603642
Report Date: 02/23/2024
Date Signed: 02/23/2024 02:54:29 PM

Document Has Been Signed on 02/23/2024 02:54 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:LOL - LIFE OF LIBERTY, LLCFACILITY NUMBER:
374603642
ADMINISTRATOR:MUNOZ, CLAUDIAFACILITY TYPE:
775
ADDRESS:320 N. HORNE STREETTELEPHONE:
(760) 433-5411
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY: 100CENSUS: 52DATE:
02/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Licensee Debrah Howard, Chief Personal Assistant Andruw Lynch and Hannah BultemeierTIME COMPLETED:
02:54 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA were welcomed by, identified themselves to, and discussed the purpose of the visit with Chief Personal Assistant Andruw Lynch and was shortly joined by Licensee Debra Howard and Office Manager Hannah Bultemeier.

According to the facility’s license, there may be a maximum of hundred (100) clients at any given time at the day program site, seventy-five (75) of which must be ambulatory an (twenty five) 25 may be non-ambulatory. During today’s inspection, there were fifty two (52) clients present at the day program site. The facility does not feature a secured perimeter or delayed egress doors.

LPAs, accompanied by licensee and staff, toured the interior and exterior of the day program facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Doors, windows and screens, sinks, and toilets were in working order. Hand hygiene supplies and Personal Protective Equipment were present. The facility had sufficient space and equipment to facilitate visitation, meetings, and client activities. The facility’s ambient internal temperature was comfortable and compliant, at 69F. Hot water temperature at taps accessible to clients were compliant.

There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible.

(CONTINUED ON LIC809-C)
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Juliana Barfield
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: LOL - LIFE OF LIBERTY, LLC
FACILITY NUMBER: 374603642
VISIT DATE: 02/23/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(CONTINUED FROM LIC809)

LPA interviewed multiple staff and clients. LPA also reviewed multiple staff and client records. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. Licensee also presented proof of current/active business liability insurance. Required licensing postings were observed in visible areas of the facility.

An exit interview was conducted with Debra Howard, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.


SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Juliana Barfield
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2