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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604171
Report Date: 12/21/2022
Date Signed: 12/22/2022 09:51:55 AM


Document Has Been Signed on 12/22/2022 09:51 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:LO-HAR SENIOR LIVINGFACILITY NUMBER:
374604171
ADMINISTRATOR:DUCHARME-FRANKLIN, KANDYFACILITY TYPE:
740
ADDRESS:768 DOROTHY STTELEPHONE:
(619) 444-8270
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:68CENSUS: 59DATE:
12/21/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Administrator Kandy Franklin,TIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Case Management visit to follow-up on an incident reported to Community Care Licensing. LPA met with Administrator Kandy Franklin, and we discussed the purpose of the visit.

Community Care Licensing received an incident report on 12/20/2022 in which it was reported that Resident #1 (R1) went absent without official leave (AWOL) from the facility on 12/17/2022. R1 returned to the facility on 12/17/2022, same day. Per records reviewed licensee followed absentee notification plan as necessary.

During today's visit, LPA conducted a health and safety check of the residents in care and provided consultation. No deficiencies were cited during today’s visit.

An exit interview was conducted with Administrator Kandy Franklin. The Licensee was provided a copy of their appeal rights (LIC9058 03/22), LIC811, this report and their signature on this form, acknowledges receipt of these rights.
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Iby StrongTELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:
DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/21/2022
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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