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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604310
Report Date: 11/03/2022
Date Signed: 11/03/2022 04:11:28 PM


Document Has Been Signed on 11/03/2022 04:11 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:SUNVIEW GARDENS 2FACILITY NUMBER:
374604310
ADMINISTRATOR:ARCANGELI, FELICITYFACILITY TYPE:
740
ADDRESS:13608 AUBREY STREETTELEPHONE:
(858) 342-9431
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:15CENSUS: 10DATE:
11/03/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
11:11 AM
MET WITH:Benancia "Mina" Morales, CaregiverTIME COMPLETED:
12:09 PM
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Licensing Program Analyst (LPA) Esther Miller conducted an unannounced case management visit on today's date. LPA was greeted and granted entry by Benancia "Mina" Morales, Caregiver, after identifying herself and disclosing the purpose of the visit. Felicity Arcangeli, Administrator arrived later during the visit.

The Department did not receive incident reports for COVID positive residents in the facility. Guidance was provided on COVID reporting requirements. LPA conducted a brief tour of the facility and found to be in compliance with their LIC808 and infection control plan. Facility had more than a 30 day supply of PPE, food supplies, medication, and cleaning products.

LPA did observe that COVID screening questions were placed next to the visitor log. Caregiver stated that staffLPA provided guidance on PIN 22-07-ASC regarding visitation.

No deficiencies were observed during today's visit. An exit interview was conducted with Caregiver and a copy of this report along with Licensee/Appeal Rights (LIC9058) were provided.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Esther MillerTELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022
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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