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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604426
Report Date: 03/13/2023
Date Signed: 03/13/2023 10:57:39 AM


Document Has Been Signed on 03/13/2023 10:57 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:RIDGEVIEW ASSISTED LIVING COMMUNITYFACILITY NUMBER:
374604426
ADMINISTRATOR:DAYNES, ROBERTFACILITY TYPE:
740
ADDRESS:9825 GLEN CENTER DRIVETELEPHONE:
(858) 444-8560
CITY:SAN DIEGOSTATE: CAZIP CODE:
92131
CAPACITY:68CENSUS: 61DATE:
03/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:56 AM
MET WITH:Administrator Robert Daynes and Community Laison Kathy DemosTIME COMPLETED:
11:00 AM
NARRATIVE
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Licensing Program Analysts (LPA) Dang Nguyen and Alyssa Ramirez conducted an unannounced Case Management Visit to observe the physical plant. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Community Liason Kathy Demos. LPA's then met and discussed the purpose of the visit with Administrator Robert Daynes.

On 12-29-2022, the Licensee submitted an LIC200 Application to the CCLD San Diego Regional Office (RO) to change the facility's total licensed capacity from sixty-four (64) non-ambulatory residents up to sixty-eight (68) non-ambulatory residents.

On 01-11-2023, the local fire authority granted an updated fire clearance, reflecting the facility was approved for sixty-eight (68) residents in total, all of whom may be non-ambulatory. The facility’s floor plan remained unchanged.

LPA's conducted a tour of the facility and observed no immediate health or safety issues. No deficiencies were cited. The facility sketch/floor plan was consistent with the current layout of the facility.

This portion of the application process has been completed. The Licensee will be sent an updated license to reflect the new fire clearance after CCLD management’s final review and approval.



An exit interview was conducted with Daynes, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang NguyenTELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
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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