<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604353
Report Date: 12/29/2020
Date Signed: 12/29/2020 02:01:05 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:MAJELLA ASSISTED LIVING, LLCFACILITY NUMBER:
374604353
ADMINISTRATOR:MORRISON, JIMFACILITY TYPE:
740
ADDRESS:2590 MAJELLA RD.TELEPHONE:
(760) 216-6344
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:12CENSUS: 9DATE:
12/29/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Administrator Jim Morrison TIME COMPLETED:
11:40 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Manager (LPM) John Rante, County of San Diego Senior Public Health Nurses, Robert Montillanorey Meilander, and California Department Public Health (CDPH), Health Facility Evaluator Nurse (HFEN), Denise Elliot, conducted an in-person visit.

LPM and team identified themselves and discussed the purpose of the visit with Administrator, James Morrison.

The Department conducted an on-site visit to provide technical assistance and to evaluate the facility's disinfection and screening protocols. During today's visit, the team interviewed the Administrator and provided consultation and conducted a walk-though of the facility. A debriefing was conducted with the Administrator at the conclusion of the visit.

During today's visit, no deficiencies were issued. An exit interview was conducted with Mr. Morrison, and a copy of this report, along with Licensee Rights (LIC 9058 01/16), were provided to the Administrator via electronic mail. An electronic receipt of confirmation was requested to be sent by the Administrator upon receipt of the documents.
SUPERVISOR'S NAME: Icela EstradaTELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1