374604418-2-23-2024-08-AS-MGCO-D2R3P9-20240223172511

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374604418
Report Date: 02/23/2024
Date Signed: 02/23/2024 05:25:58 PM

Document Has Been Signed on 02/23/2024 05:25 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	EL CERRITO ADULT RESIDENTIAL FACILITY		FACILITY NUMBER:	374604418
ADMINISTRATOR:	WESNER, PAUL		FACILITY TYPE:	735
ADDRESS:	4593 EL CERRITO DRIVE		TELEPHONE:	(619) 980-7043
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY: 4		CENSUS: 4	DATE:	02/23/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Administrator, Randy Hill		TIME COMPLETED:	04:15 PM

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 Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required Annual Inspection. The facility file was reviewed before the visit. LPA identified herself and was granted entry by Administrator, Randy Hill, to whom she disclosed the purpose of the visit. All staff present had current criminal record clearance. According to the facility’s license, the facility has a maximum capacity of four (4) ambulatory in the transitional residential program. There were a total of four (4) clients in care, of which all were ambulatory. Two (2) client were at the facility during the inspection. LPA Garcia-Centeno was accompanied by Administrator, Randy Hill while touring the interior and exterior of the facility. In addition, the clients’ rooms were inspected. The facility was clean and in good repair. Pathways were free of obstruction and slip hazards. The clients’ bedrooms contained the required furnishings. The doors, toilet, and shower were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities for the residents in care. The facility’s internal temperature, refrigerator, and freezer temperatures were within the regulatory range. During today’s visit, LPA observed, via measurement with a thermometer, that the hot water temperature from the kitchen faucet accessible to clients was within regulatory range. There were at least two (2) days of perishable food, and at least 7 days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. (Continue at LIC809C

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: EL CERRITO ADULT RESIDENTIAL FACILITY	FACILITY NUMBER: 374604418
	VISIT DATE: 02/23/2024

NARRATIVE

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(Continue from LIC809)

Medications were labeled, as required and stored in locked areas. Confidential client and staff records were appropriately stored. No pools or bodies of water were observed on the premises. Per the staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. The fire extinguisher was serviced within the last 12 months. The first aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

LPA interviewed staff and clients present during the visit and reviewed staff and clients' records. LPA staff interviews and clients did not raise any licensing concerns. The clients' files that LPA reviewed contained the required documents. Staff records contained proof of current first aid training. The administrator presented proof of current/active business liability insurance and surety bond as required by Title 22 regulations.

No deficiencies were cited or observed on this date.

The Licensee was provided a copy of her appeal rights (LIC9058 01/16). An exit interview was conducted with Administrator, Hill to whom a copy of this report was provided at the end of the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

LIC809 (FAS) - (06/04)

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