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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603785
Report Date: 11/29/2021
Date Signed: 11/29/2021 05:03:04 PM

Document Has Been Signed on 11/29/2021 05:03 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:PARADISE CARE HOMESFACILITY NUMBER:
374603785
ADMINISTRATOR:EPPS, RHONDAFACILITY TYPE:
735
ADDRESS:2043 ALBERQUE CTTELEPHONE:
(619) 470-0504
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY: 4CENSUS: 4DATE:
11/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Administrator, Rhonda EppsTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Lizzette Tellez visited the facility to conduct an annual required licensing inspection. LPA met with Administrator, Rhonda Epps, and discussed the purpose of the visit.

During today's visit, LPA toured the facility, and verified compliance with infection control practices. LPA and Ms. Epps reviewed the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of cleaning products and PPE.

No deficiencies were cited during today’s visit. An exit interview was conducted with Ms. Epps, and a copy of this report, along with the Licensee Rights (LIC 9058 FAS 01/16) were provided to them via email. An electronic receipt of confirmation was requested to be sent by the Administrator upon receipt of the documents.
NAME OF LICENSING PROGRAM MANAGER: John Rante
NAME OF LICENSING PROGRAM ANALYST: Lizzette Tellez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2021
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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