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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604339
Report Date: 09/22/2023
Date Signed: 09/22/2023 11:28:01 AM

Document Has Been Signed on 09/22/2023 11:28 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:SIENA HOME CARE LLCFACILITY NUMBER:
374604339
ADMINISTRATOR:MASCARDO, ERLINDAFACILITY TYPE:
735
ADDRESS:282 S SIENA ST.TELEPHONE:
(619) 470-0908
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY: 4CENSUS: 3DATE:
09/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Erlinda Mascardo, AdministratorTIME COMPLETED:
11:35 AM
NARRATIVE
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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint investigation and in conjunction conducted a case management visit. LPA Lopez identified herself and was granted entry by Erlinda Mascardo, Administrator. LPA stated the purpose of the visit and reviewed the basic elements of the visit with Administrator Mascardo.

During today’s visit, LPA toured the facility, conducted staff and client interviews, and requested and obtained relevant records.

During the complaint investigation, there noted concerns regarding food service, specifically availability of snacks for clients; ants in the kitchen area; and staff not being respectful towards clients.

LPA’s observations notes that there were few ants on a counter top. There was sufficient food in both of the refrigerators and cabinets. The facility does have a schedule on the refrigerator door with snacks annotated. LPA did observe that the snacks on the schedule were available. There were two staff at the facility and the Administrator during the time of the visit. Although no deficiencies are being cited today, the facility was provided with technical assistance regarding the following Title 22 regulations: Section 80076 Food Service; and Section 80072 Personal Rights.

An exit interview was conducted with Administrator Mascardo and a copy of this report, along with the Licensee/Appeal Rights (LIC 9058 03/22) were provided to the Administrator Mascardo at the conclusion of the visit. The signature below serves as receipt of confirmation that the documents were received.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Carmen Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2023
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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