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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604318
Report Date: 04/28/2023
Date Signed: 04/28/2023 01:25:30 PM


Document Has Been Signed on 04/28/2023 01:25 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
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:WESTMONT OF ENCINITASFACILITY NUMBER:
374604318
ADMINISTRATOR:NEWTON, RANDALFACILITY TYPE:
740
ADDRESS:1920 SOUTH EL CAMINO REALTELEPHONE:
(760) 452-6037
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY:101CENSUS: 81DATE:
04/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Randal Newton, Executive DirectorTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Case Management visit regarding an Incident Report that was submitted to the San Diego Regional Office by the Licensee. LPA was granted entry into the facility and met with Randal Newton, Executive Director, to whom the purpose of the visit was disclosed.

During today's visit LPA toured the facility, conducted a resident interview and completed a Health and Safety check with residents, and collected facility records. No deficiencies were cited during this visit.

An exit interview was conducted with Randal Newton, Executive Director. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided and their signature on this report confirms receipt of the Licensee Rights.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:
DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2023
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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