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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603734
Report Date: 05/08/2024
Date Signed: 05/08/2024 02:17:28 PM

Document Has Been Signed on 05/08/2024 02:17 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:SHINING STAR ADULT DAY CARE INCFACILITY NUMBER:
374603734
ADMINISTRATOR/
DIRECTOR:		GRIGGS, LAURA CASASFACILITY TYPE:
775
ADDRESS:333 E STREETTELEPHONE:
(619) 651-7446
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 30CENSUS: 28DATE:
05/08/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Laura Casas GriggsTIME VISIT/
INSPECTION COMPLETED:
02:29 PM
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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, and discussed the purpose of the visit with Administrator Laura Casas Griggs.

According to the facility’s license, there may be a maximum of thirty (30) adults. All of whom must be ambulatory. During today’s inspection, there were twenty eight (28) clients present at the day program site. The facility does not feature a secured perimeter or delayed egress doors.

LPA, accompanied by the Administrator, toured the interior and exterior of the facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Doors, windows, 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 meetings and client activities. The facility’s ambient internal temperature was comfortable and compliant, at 72 degrees F. Hot water temperature at taps accessible to clients were also compliant: Kitchen sink was 118 degrees F, restroom sinks deliver hot water at 117 degrees F. No consumers currently take medications (prescription) at the program, LPA inspected the medication cabinet where medications are locked and secured.

No pools or bodies of water on the premises. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients.

[CONTINUED ON LIC809-C]

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2024
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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SHINING STAR ADULT DAY CARE INC
FACILITY NUMBER: 374603734
VISIT DATE: 05/08/2024
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accessible to clients. Per the Administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguishers (5) were serviced within the last 12 months. First aid kits were complete and readily accessible.

LPA interviewed staff. LPA interviews did not raise any licensing concerns. LPA reviewed multiple staff and client records/files. The files contained required documents. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility.

No deficiencies were observed or cited during today's visit.

An exit interview was conducted with Laura Casas-Griggs, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC809 (FAS) - (06/04)
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