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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604232
Report Date: 01/23/2025
Date Signed: 01/23/2025 03:46:59 PM

Document Has Been Signed on 01/23/2025 03:46 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/
DIRECTOR:
TERRI BOSTIANFACILITY TYPE:
740
ADDRESS:16922 HIERBA DRIVETELEPHONE:
(858) 673-6333
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY: 140TOTAL ENROLLED CHILDREN: 0CENSUS: 54DATE:
01/23/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Raquel Mathews, Director of Health and WellnessTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced case management, delivered findings for a complaint investigation and in conjunction performed a required Annual Inspection visit. The facility file was reviewed prior to the visit. LPA Lopez identified herself, was granted entry by concierge Sabrina Uchino and Geizel Dasig. LPA discussed the purpose of the visit with Director of Health and Wellness Raquel Mathews.

According to the facility’s license, there may be a maximum of 140 ambulatory residents of which 82 may be non-ambulatory and 16 may be bedridden in at any given time at the facility site. A hospice waiver is approved for 22 residents. During today’s inspection, the facility’s current census is 54 residents living at the facility. There were 54 residents present at the facility site during the inspection.

During today's visit, LPA reviewed facility records and will complete the review of records at a later date. Due to time constraints, the inspection could not be completed, and a subsequent visit will be conducted at a later date to complete the required annual inspection.

There were no deficiencies observed or cited during today’s visit.

An exit interview was conducted with Director of Health and Wellness Raquel Mathews, to whom a copy of this report along with the Licensee Rights (LIC9058 3/22) were provided at the conclusion of the visit. The signature below confirms the documents were received.
Robyn ClarkTELEPHONE: (619) 767-2312
Carmen LopezTELEPHONE: (619) 767-2301
DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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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