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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604325
Report Date: 07/31/2020
Date Signed: 07/31/2020 12:55:46 PM

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:MARAMAFACILITY NUMBER:
374604325
ADMINISTRATOR:SANDISON, HEATHERFACILITY TYPE:
740
ADDRESS:727 ASCOT DRIVETELEPHONE:
(760) 941-9208
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:12CENSUS: 6DATE:
07/31/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Applicant Dr. Heather SandisonTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Raymond Wu conducted an announced Pre-licensing and Component III visit, via FaceTime due to COVID-19, to observe the physical plant for compliance with Title 22, Division 6, of the CA Code of Regulations and Health & Safety Codes. LPA was met by Applicant, Dr. Heather Sandison.

A virtual tour of the facility was conducted. LPA observed resident accommodations, including furnishings, linens, and personal hygiene items. Bathrooms used by residents in care were equipped with grab bars and non-skid mats. Resident and staff records were stored in a file cabinet and will be accessible to Community Care Licensing upon request. Food service, including dishes, utensils, and food storage were observed. A seven day supply of non-perishable and a two day supply of perishables food items were present. Toxic substances were stored in areas inaccessible to residents. Medication and a first aid kit, including manual, were located in a locked hallway closet. Activities, supplies, and sufficient space to conduct activities are present. Smoke and carbon monoxide detectors were present and operable. Facility postings were present in a common area, and the administrator’s certification is current. The facility property does not have any pool or body of water, and, according to the applicant, there are no guns, weapons, or ammunition stored on the property. Component III was conducted and completed during the visit. The facility is ready for licensure pending final management approval.

An exit interview was conducted with Sandison and a copy of this report, along with Applicant Rights (LIC 9058), was provided to the Applicant via electronic mail. An e-mail read receipt confirms acceptance of these documents.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Raymond WuTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2020
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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