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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604095
Report Date: 10/29/2024
Date Signed: 10/29/2024 03:32:14 PM

Document Has Been Signed on 10/29/2024 03:32 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:HUNTINGTON CHATEAUFACILITY NUMBER:
374604095
ADMINISTRATOR/
DIRECTOR:
KIRSTEN THRUSHFACILITY TYPE:
740
ADDRESS:14934 HUNTINGTON GATE DRTELEPHONE:
(858) 231-4126
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
10/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Administrator Tess DeraferaTIME VISIT/
INSPECTION COMPLETED:
03:45 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) Ryan Fulton 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 to Administrator Tess Derafera. The facility's license shows a maximum capacity of Six (6) residents. During today’s inspection there were Six (6) Residents in care.

LPA and Administrator Tess Derafera 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. resident 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 to residents. Medications were labeled, as required, and stored in locked areas. The facility’s ambient internal temperature was compliant. Hot water temperature at taps accessible to residents were all compliant: Kitchen sink was 105 F; bathroom #1 sink was 105 F and bathroom #2 sink was 105 F.

Pool was Locked and secure with a 6 foot fence around the entire perimeter. Per administrator, 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 .First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

An exit interview was conducted with Administrator Tess Derafera to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit
Jennifer LottTELEPHONE: (619) -76-2311
Ryan FultonTELEPHONE: 619-629-8938
DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
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 1