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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604456
Report Date: 05/09/2022
Date Signed: 05/10/2022 09:41:33 AM


Document Has Been Signed on 05/10/2022 09:41 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:SAY YOU'RE HOMEFACILITY NUMBER:
374604456
ADMINISTRATOR:SAYRE, LISA HENDERLINGFACILITY TYPE:
740
ADDRESS:5971 LAKE MURRAY BLVD.TELEPHONE:
(619) 466-6993
CITY:LA MESASTATE: CAZIP CODE:
91942
CAPACITY:6CENSUS: 6DATE:
05/09/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Caregivers Floredeliza "Flor" Galura and Emily Nightingale, and Licensee Lisa SayreTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Collateral Visit. LPA was greeted by, identified himself to, and discussed the purpose of the visit with caregivers Floredeliza "Flor" Galura and Emily Nightingale. Licensee Lisa Sayre later joined the visit via phone call.

During today’s visit, LPA briefly toured the facility. LPA also interviewed a resident and staff and collected records in connection with an ongoing investigation regarding a different licensed care facility. No deficiencies were cited during this visit.

An exit interview was conducted with Galura and Sayre. A copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided to the licensee.

SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang NguyenTELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2022
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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