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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604013
Report Date: 05/17/2024
Date Signed: 05/17/2024 12:29:52 PM

Document Has Been Signed on 05/17/2024 12:29 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:CROWNVIEW PSYCHIATRIC INSTITUTE INC.FACILITY NUMBER:
374604013
ADMINISTRATOR/
DIRECTOR:		BRITTANY PERKINSFACILITY TYPE:
772
ADDRESS:1110 CAMINO DEL SOL CIRCLETELEPHONE:
(760) 231-1170
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY: 6CENSUS: 5DATE:
05/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Melissa MartinezTIME VISIT/
INSPECTION COMPLETED:
12:35 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 Analysts (LPAs) Ryan Fulton and Carmen Lopez 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 Melissa Martinez. the facility's license shows a maximum capacity of six (6) clients, of which all are ambulatory. During today’s inspection there were Five (5) clients in care.

LPAs and Melissa Martinez 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, screens, 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 client activities.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all of which are safely stored. Cooking/dining equipment and utensils were present. Toxic chemicals/poisons were locked and inaccessible accessible to clients. Medications were labeled, as required, and stored in locked areas. Hot water temperature at taps accessible to clients were all compliant: Kitchen sink was 107.2 F, bathroom #1 sink was 110.1 F and bathroom #2 sink was 113.2.F

All bodies of water were observed to be in good repair and surrounds the entire pool. The fence is designed and installed so that it is not removeable. The fence is at least five feet high and constructed not to obscure the view from the pool. The pool gate swing away from the pool. Per Director Melissa fencing will remain in place and properly functioning whenever there are licensed clients in care. Ladder will remain inaccessible whenever there are clients in care. Per licensee, no firearms or ammunition are kept at the facility. Carbon monoxide/Smoke detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Ryan Fulton
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2024
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: CROWNVIEW PSYCHIATRIC INSTITUTE INC.
FACILITY NUMBER: 374604013
VISIT DATE: 05/17/2024
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
No deficiencies were cited during the inspection.

An exit interview was conducted with Licensee Melissa Martinez to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit The signature below confirms these documents were received.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Ryan Fulton
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2