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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604345
Report Date: 03/05/2021
Date Signed: 03/05/2021 04:14:39 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:RANCHO DIGIUSFACILITY NUMBER:
374604345
ADMINISTRATOR:MONTES, FROILANFACILITY TYPE:
735
ADDRESS:2445 BROADWAYTELEPHONE:
(858) 717-0346
CITY:SAN DIEGOSTATE: CAZIP CODE:
92102
CAPACITY:49CENSUS: 0DATE:
03/05/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Friolan MontezTIME COMPLETED:
04:26 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kennedy conducted a Prelicensing/Component III Visit via video calling app due to COVID-19 restrictions to observe the physical plant for compliance. Present on the video call were, Friolan Montez, administrator, Zahra Digius, applicant and Jatana Williams, consultant. The LPA was provided with a virtual tour by Mr. Montaz. LPA observed resident accommodations including furnishings, linens and personal hygiene items; resident bathrooms located in convenient locations throughout the facility. Bathrooms were equipped with grab bars and paper towel dispensers; resident and staff and administrative records are to be located in a locked office in locked cabinets; food service including dishes, utensils, food storage and a seven day supply of nonperishables and a two day supply of fresh perishables are present; toxic substances are stored locked in the kitchen and locked supply rooms; medication storage and administration logs are located in a dedicated medication room with plenty of room for securing medications and maintaining medication records; first aid kit is located in the medication room; activities, supplies and sufficient space to conduct are present; fire extinguishers are affixed with a current tags; smoke and carbon monoxide detectors are present and operable; facility posting requirements are present in a common area and the facility administrators certification is current; no pool or other body of water is on the facility grounds; there are no guns, weapons or ammunition located on the property. Discussed with Mr. Montes, Ms Digius and Ms. Williams were continuing operation requirements, record keeping and physical plant compliance. The applicant shall contact the Centralized Application Unit (CAU) for completion of this pending facility application.

An exit interview was conducted with Mr. Montez, and a copy of this report and Licensee Appeal Rights (LIC 9058) were emailed for facility records.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Anna KennedyTELEPHONE: (619) 997- 4108
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2021
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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