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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604050
Report Date: 02/01/2022
Date Signed: 02/01/2022 03:58:14 PM

Document Has Been Signed on 02/01/2022 03:58 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:BRIGHT HOME BOARD & CAREFACILITY NUMBER:
374604050
ADMINISTRATOR:SANTELLA, JOCELYNFACILITY TYPE:
735
ADDRESS:5881 GREWIA STREETTELEPHONE:
(619) 512-1151
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY: 4CENSUS: 3DATE:
02/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Jocelyn Santella, LicenseeTIME COMPLETED:
02:55 PM
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Licensing Program Analyst (LPA) Dawn Segura conducted a case management visit to investigate a client death. A Death Report was received by Community Care Licensing (CCL) on 1/31/2022 informing of the death of Client 1 (C1) [an LIC 811 Confidential Names List was provided to identify the client] that occurred on 1/30/2022.

LPA was granted entry into the facility and met with Jocelyn Santella, Licensee, with whom she discussed the purpose of the visit. During today's visit, LPA toured the facility, obtained copies of client records, and interviewed staff. No deficiencies were cited during the visit.

An exit interview was conducted with the licensee, and a copy of this report and licensee appeal rights will be provided via electronic mail following the visit. Confirmation of receipt is requested to be sent to LPA upon receipt of the documents.
SUPERVISORS NAME: Rebecca Hedgecock
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2022
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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