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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604477
Report Date: 10/11/2022
Date Signed: 10/13/2022 05:08:09 PM

Document Has Been Signed on 10/13/2022 05:08 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SCARLETT'S CAREFACILITY NUMBER:
374604477
ADMINISTRATOR:SORENSON, BRADLEYFACILITY TYPE:
735
ADDRESS:1024 NEPTUNE DRIVETELEPHONE:
(619) 634-1889
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 4CENSUS: 0DATE:
10/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:House Manager, Reynaldo PuaTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA), Marisela Garcia-Centeno conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPA met with House Manager, Reynaldo Pua and we discussed the purpose of the visit. The facility file was reviewed prior to the visit. All staff present have a current criminal record clearance.

LPA conducted a tour of the facility. There are currently no clients in care. LPA spoke with Administrator, Bradley Sorenson who confirmed San Diego Regional Center is in the process of approving their program. LPA toured the facility both inside and outside and observed the clients' rooms with all the required furnishings. The kitchen was fully stocked with 7 day food supply of non perishable items and 2 day supply of perishables. In accordance with the Department’s Infection Control, LPA provided technical assistance, evaluated, and observed the facility's implementation of their infection control plan to include disinfection, testing surveillance, and screening protocols as well as the use of personal protective equipment.

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 House Manager, Pua, to whom a copy of this report was provided at the conclusion of the visit.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2022
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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