374603761-4-18-2024-08-AS-CLOZ-D4FSAD-20240418134210

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374603761
Report Date: 04/18/2024
Date Signed: 04/18/2024 01:43:46 PM

Document Has Been Signed on 04/18/2024 01:43 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:	P & P HOMES INC		FACILITY NUMBER:	374603761
ADMINISTRATOR:	ORDINANZA, PAULO C		FACILITY TYPE:	740
ADDRESS:	146 WEDGEWOOD DRIVE		TELEPHONE:	(858) 327-0429
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92114
CAPACITY:	6	CENSUS: 5	DATE:	04/18/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Paulo Ordinanza, Administrator		TIME COMPLETED:	01:55 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) Carmen Lopez conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA Lopez identified herself, was granted entry by caregivers Editha Cuizon and Jonathan Luciano. LPA discussed the purpose of the visit with Licensee Precy Ordinanza-Hulburd. Administrator Paulo Ordinanza later arrived and joined the visit. According to the facility’s license, there may be a maximum of six (6) residents all of whom may be non-ambulatory of which 6 may be bedridden; and hospice waiver is approved for 2, in at any given time at the facility site. During today’s inspection, the facility’s current census is 5 residents living at the facility. There were 5 residents present at the facility site during the inspection. LPA, accompanied by Licensee Ordinanza-Hulburd and Administrator Ordinanza, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. The facility’s ambient internal temperature was comfortable and compliant, at 70.7 degrees Fahrenheit (F). Hot water temperature at taps accessible to residents were also compliant: kitchen sink was delivered hot water at 112.8 degrees F; sink in restroom #1 delivered hot water at 109.4 degrees F; and sink in restroom #2 delivered hot water at 109.4 degrees F. [CONTINUED ON LIC 809-C]

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) -34-3976
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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: P & P HOMES INC	FACILITY NUMBER: 374603761
	VISIT DATE: 04/18/2024

NARRATIVE

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[CONTINUED FROM LIC 809]

There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present, and all safely stored. There were no toxic chemicals/poisons accessible to residents. Medications were properly labeled, as required, and stored in a locked area. LPA inspected the office area where the medication cabinet was located and found that medications were properly labeled and stored in a locked cabinet. The facility-maintained medication logs which LPA reviewed.

No pools or bodies of water on the premises. Per Administrator Ordinanza, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present (01) and serviced within the last 12 months. First aid kit(s) were complete and readily accessible.

LPA interviewed staff and resident, and reviewed staff and resident records. During today’s visit there were 5 residents on the facility premise. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in a locked area. Required licensing postings were observed in a visible area of the facility.

There were no deficiencies observed or cited during today's annual inspection.

An exit interview was conducted with Administrator Paulo Ordinanza and Licensee Precy Ordinanza-Hulburd to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received.

LPA requested Administrator Paulo Ordinanza to submit a current Designation of Administrative Responsibility LIC 308, and Personnel Report LIC 500, to the licensing office within 10 business days. Forms are available at www.ccld.ca.gov. The facility provided an updated copy of the Emergency Disaster Plan LIC 610-E to LPA during the inspection.

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) -34-3976
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC809 (FAS) - (06/04)

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