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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604227
Report Date: 09/09/2022
Date Signed: 09/09/2022 12:36:25 PM


Document Has Been Signed on 09/09/2022 12:36 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:SUMMERFIELD OF ENCINITASFACILITY NUMBER:
374604227
ADMINISTRATOR:MYERS,HEATHERFACILITY TYPE:
740
ADDRESS:1350 S. EL CAMINO REALTELEPHONE:
(760) 479-1818
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY:56CENSUS: 33DATE:
09/09/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Heather Myers, Executive DirectorTIME COMPLETED:
12:40 PM
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Licensing Program Analyst’s (LPA’s) Carmen Lopez and Liliana Silveira conducted an unannounced collateral visit to the facility to conduct interviews. LPA’s Lopez and Silveira identified themselves and stated the purpose of the visit with Heather Myers Executive Director (ED), Richard Mariona, Residence Service Director (RSD), and Claudia Miner, Community Relations Director.

During the visit, LPA Lopez and Silveira interviewed outside source, staff and resident #1 (R1)(See LIC811 Confidential Names), and requested and obtained relevant documents. No deficiencies were observed during today's visit.

An exit interview was conducted with Executive Director Myers and Resident Service Director Mariona. A copy of this report along with Licensee/Appeal Rights (LIC9058 01/16) was provided to Heather Myers, Executive Director, at the conclusion of the visit. The signature below confirms the receipt of the documents.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Carmen LopezTELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2022
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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