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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604232
Report Date: 09/06/2024
Date Signed: 09/06/2024 01:54:18 PM


Document Has Been Signed on 09/06/2024 01:54 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:REMINGTON CLUB IIFACILITY NUMBER:
374604232
ADMINISTRATOR:TERRI BOSTIANFACILITY TYPE:
740
ADDRESS:16922 HIERBA DRIVETELEPHONE:
(858) 673-6333
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY:140CENSUS: 70DATE:
09/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Matthew Ryan, Executive DirectorTIME COMPLETED:
02:00 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), Carmen Lopez, conducted an unannounced visit to initiate a case management visit. LPA Lopez identified herself and was granted entry by Raquel Matthews, Director of Health and Wellness. LPA Lopez stated the purpose of the visit and reviewed the basic elements of the visit with Director of Health and Wellness Matthews. Executive Director Matthew Ryan later arrived and joined the visit.

This visit was in response to an Unusual Incident/Injury Report (IR) that was received at the San Diego Regional Office on July 23, 2024. The IR said that the Assisted Living was undergoing work on their air conditioning units.

During today's visit LPA Lopez spoke with staff, toured the facility, and requested and obtained relevant documents pertinent to this incident. According to the Health and Wellness Director Matthews the residents had portable air conditioning units and hydration stations throughout the facility. There were no issues with residents during the reparations.

No deficiencies were observed or cited during today’s visit.

An exit interview was conducted with Executive Director Mathew Ryan, and a copy of this report, and Licensee Appeal Rights (LIC9058) were provided to Executive Director Ryan at the conclusion of the visit. The signature below confirms that the documents were received.
SUPERVISOR'S NAME: Jennifer LottTELEPHONE: (619) -34-3976
LICENSING EVALUATOR NAME: Carmen LopezTELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2024
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