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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604123
Report Date: 11/06/2024
Date Signed: 11/06/2024 11:48:42 AM

Document Has Been Signed on 11/06/2024 11:48 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:MERAKEY - WYNDEMEREFACILITY NUMBER:
374604123
ADMINISTRATOR/
DIRECTOR:
BUCKINGHAM, ADELITAFACILITY TYPE:
737
ADDRESS:26184 WYNDEMERE CTTELEPHONE:
(442) 286-7548
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 4CENSUS: 4DATE:
11/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Administrator, Adelita BuckinghamTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 11/6/2024, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to conduct a required annual inspection. LPA met with Administrator, Adelita Buckingham who was informed of the purpose of the visit. The facility has a fire clearance for four (4) non-ambulatory clients and serves adults ages 18 through 59. The facility is also approved for delayed egress.

LPA toured the facility with Administrator Buckingham. The facility is made up of a one (1) story home with four (4) client bedrooms, three (3) client bathrooms, a staff office, kitchen, dining room, living room, and attached garage. During the tour, Administrator Buckingham tested the delayed egress and LPA observed it to be operational. Outside shaded seating is available for client use. Indoor and outdoor passageways are free of obstruction. Assistant Administrator, Adrian Arias tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed the alarms to be operational. LPA also observed charged fire extinguishers mounted in the hallway that were last serviced on 7/2/2024. No bodies of water were observed on the premises. LPA toured the kitchen and observed the facility has a two-day supply of perishable foods and seven-day supply of non-perishable food items. Cleaning solutions, disinfectants, knives and sharp instruments are secured in the garage. Medications are secured in a locked kitchen cabinet. LPA and Assistant Administrator Arias reviewed the Medication Administration Record for Client 1 (C1) and Client 2 (C2) along with their physical medications and no discrepancies were discovered. LPA was informed the facility does not safeguard the clients' cash resources. LPA reviewed C1 and C2's client files, which had updated Individual Program Plans and signed admission agreements. A record review revealed Staff 1 and Staff 2 have a valid first aid/cardiopulmonary and non-violent crisis intervention certificates. Administrator Buckingham's administrator certificate expires on 1/1/2025.

During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Administrator Buckingham along with a Confidential Names list (LIC 811).

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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