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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604176
Report Date: 08/06/2020
Date Signed: 08/06/2020 03:58:11 PM

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:ALTA VISTA SENIOR LIVINGFACILITY NUMBER:
374604176
ADMINISTRATOR:ALSPACH, DAVIDFACILITY TYPE:
740
ADDRESS:2041 W VISTA WAYTELEPHONE:
(760) 941-3233
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:98CENSUS: 88DATE:
08/06/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Executive Director David AlspachTIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA), Raymond Wu, contacted the facility via telephone regarding a Case Closure. The visit was conducted virtually through FaceTime due to COVID-19. LPA identified themselves and explained the purpose of the visit to Executive Director David Alspach.

During the call, no indications suggested that Staff #1 (S1, see List of Confidential Names) was present at the facility.

Per interviews conducted, S1 has been working from home and has not stepped foot in the building. Staff stated that they had not seen S1 in the facility since being advised that S1 needed an exemption to work inside the facility.

No deficiencies were observed on this date.

An exit interview was conducted via telephone, and a copy of this report and Licensee's Rights (9058 01/16) were e-mailed to the Executive Director David Alspach. A confirmation of receipt was requested to be sent back.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Raymond WuTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020
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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