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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604281
Report Date: 07/26/2021
Date Signed: 07/27/2021 08:13:48 AM

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:OAKMONT OF PACIFIC BEACHFACILITY NUMBER:
374604281
ADMINISTRATOR:AMIRHOUSHMAND,SHAWNFACILITY TYPE:
740
ADDRESS:955 GRAND AVETELEPHONE:
(858) 373-9300
CITY:SAN DIEGOSTATE: CAZIP CODE:
92109
CAPACITY:92CENSUS: 78DATE:
07/26/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Health Service Director Rebecca Casella & Executive Director Caroline SentenoTIME COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Dang Nguyen and Rebecca Ruiz conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPAs were greeted by, identified themselves to, and were granted entry to the facility by Concierge Jannette Hernandez. LPAs met with Health Service Director Rebecca Casella and discussed the purpose of the visit. Executive Director Caroline Senteno arrived later during the visit. All staff present have a current criminal record clearance.

LPAs conducted a brief tour of the facility, both inside and outside, and observed the clients in care. In accordance with the Department’s Infection Control, LPAs provided technical assistance and observed and evaluated the facility's implementation of their COVID-19 Mitigation Plan, to include disinfection, testing surveillance, screening protocols, and the use of personal protective equipment. No deficiencies were cited or observed on this date.

An exit interview was conducted with Executive Director Caroline Senteno, to whom a copy of this report and the licensee appeal rights (LIC9058 01/16) were provided via E-mail.
SUPERVISOR'S NAME: Alexandre VoTELEPHONE: (619) 385-7506
LICENSING EVALUATOR NAME: Rebecca A RuizTELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021
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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