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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604270
Report Date: 02/09/2024
Date Signed: 02/20/2024 11:47:39 AM

Document Has Been Signed on 02/20/2024 11:47 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:ALLIANCE GUEST HOMEFACILITY NUMBER:
374604270
ADMINISTRATOR:CHONG, CANDYFACILITY TYPE:
735
ADDRESS:1525 OLEANDER AVENUETELEPHONE:
(619) 241-9231
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 4CENSUS: 4DATE:
02/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Administrator Candy ChongTIME COMPLETED:
04:00 PM
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Licensing Program Analysts (LPA) Liliana Silveira conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Caregiver Elizabeth DeGuia. Administrator Candy Chong arrived shortly after.

According to the facility’s license, the facility has a maximum capacity of 4 clients, age range from 18 to 59 all of whom may be non-ambulatory and 1 may be bedridden. During today’s inspection, there were a total of 4 clients in care, and per medical records, two were non-ambulatory and two were ambulatory. This facility does not feature a secured perimeter or delayed egress doors.

LPA, accompanied by Licensee, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was 68 F. Hot water temperature at taps accessible to clients were all compliant: Bathroom #1 sink was 120 F, and Bathroom #2 sink was 120 F.

No pools or bodies of water were observed on the premises. Per Licensee Candy Chong, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. Required licensing postings were observed in visible areas of the facility.

[CONTINUED ON LIC 809-C]

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: ALLIANCE GUEST HOME
FACILITY NUMBER: 374604270
VISIT DATE: 02/09/2024
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[CONTINUED FROM LIC 809] LPA interviewed multiple staff and clients. LPA reviewed multiple staff and client records/files. The interviews did not raise any significant licensing concerns. The reviewed files contained required documents. Confidential records were stored in locked areas. Licensee's staff also presented proof of current/active business liability insurance and surety bond.

Refrigerator temperature was 40 F and freezer temperature was 0 F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. During the inspection of the kitchen area, LPA observed perishable and non-perishable food items that were expired. The Licensee discarded of the food items immediately and stated she will conduct an in-service training with staff regarding checking and rotating of all food items.

No deficiencies were observed or cited during today's annual inspection. LPA issued a Technical Assistance (TA) regarding food storage of perishable and non-perishable food items. (see LIC 9172-TA).

An exit interview was conducted with Candy Chong, to whom a copy of this report, Licensee/Appeal Rights (LIC9058 03/22) and LIC 9172-TA were provided.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024
LIC809 (FAS) - (06/04)
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