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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604042
Report Date: 06/17/2021
Date Signed: 06/23/2021 01:36:46 PM

Document Has Been Signed on 06/23/2021 01:36 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:OAK HILL RESIDENTIAL CAREFACILITY NUMBER:
374604042
ADMINISTRATOR:LOFVENDAHL, BRIGITTA MFACILITY TYPE:
740
ADDRESS:612 TRANQUILITY GLENTELEPHONE:
(760) 743-8843
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 15CENSUS: 0DATE:
06/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Executive Director- Bree LofvendahlTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced annual required licensing inspection. LPA was granted entry to the main office by Business Office Director Maribel Leal and met with Executive Director Bree Lofvendahl. LPA was granted entry after identifying themselves and disclosing the purpose of the visit.

Facility is currently under construction and LPA observed temporary fencing to block entrance to the facility. LPA observed that there were no residents in care at this facility and observed the residents who were temporarily relocated to neighboring licensed facilities. The Administrator indicated that she would submit an Incident Report regarding this current status. LPA reviewed reporting requirements with Executive Director Lofvendahl.

An exit interview was conducted, and a copy of this report along with Licensee/Appeal Rights (LIC9058 01/16) was provided to Executive Director Lofvendahl via email. An electronic email receipt confirms the documents were received.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2021
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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