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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604451
Report Date: 06/16/2023
Date Signed: 06/16/2023 03:43:26 PM


Document Has Been Signed on 06/16/2023 03:43 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
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:ALTA VIEW MANORFACILITY NUMBER:
374604451
ADMINISTRATOR:AUSTRIA, VIRNA LIZA R.FACILITY TYPE:
740
ADDRESS:1727 TOBACCO ROADTELEPHONE:
(858) 705-9696
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY:6CENSUS: 5DATE:
06/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Virna Liza Austria, AdministratorTIME COMPLETED:
03:40 PM
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Licensing Program Analyst (LPA), Jacqueline Shaw Ross conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA met with Administrator Virna Liza Austria and explained the nature of the visit and was granted entry into the facility. The facility was inspected inside and out. At the time of the visit, four staff and five clients were present. LPA conducted staff and client interviews.

The home is one story and has five bedrooms, three bathrooms, and a staff office. The facility appears clean and free of odors. Client bedrooms are clean and appropriately furnished. Staff present have criminal record clearances and are appropriately associated to the facility. All smoke and carbon monoxide detectors were tested and found operable.

LPA observed facility kitchen had the ability to prepare food in a clean environment and possessed equipment in good working condition. Food supplies are sufficient. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. Hot water was measured in the client's bathroom and deemed safe at 105.6. LPA observed all toxic chemicals and other hazards secured and inaccessible to clients. Medications are centrally stored in a locked cabinet in the living room. Fixtures and furniture in the home was observed to be in good repair. Outdoor space is free of hazards.

LPA inspected the staff and client records. Staff files had the required documentation including First Aid Certifications and training documents. LPA inspected medications and medications appear to be dispensed appropriately according to the physician's orders. The facility is completing emergency drills as needed. LPA confirmed with Administrator that licensing fees are current. During the inspection, no deficiencies were observed.

An exit interview was conducted and a copy of the report and LIC 811 was provided to the Administrator.
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Jacqueline Shaw RossTELEPHONE: 951-248-0314
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2023
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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