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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604580
Report Date: 11/28/2023
Date Signed: 11/29/2023 12:13:27 AM

Document Has Been Signed on 11/29/2023 12:13 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:NATURE'S RESIDENCEFACILITY NUMBER:
374604580
ADMINISTRATOR:ANDRADE, VICTOR JOSE RFACILITY TYPE:
735
ADDRESS:8554 S SLOPE DRIVETELEPHONE:
(619) 499-5150
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: 3CENSUS: 1DATE:
11/28/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Licensee Victor AndradeTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Debbie Correia made an unannounced visit to the facility to conduct the required annual licensing inspection. LPA was met by Licensee Victor Andrade, identified herself, was granted entry into the facility, and stated the purpose of today’s visit, to inspect the facility to ensure that the facility is in compliance with the California Code of Regulations, Title 22, Division 6. There was 1 client and 1 staff present during today's visit. LPA Correia conducted a general overall inspection. The facility is licensed to serves 3 clients, ages 18 to 59, and all of whom are ambulatory.

The facility temperature was 69 degrees Fahrenheit at the time of the visit. The hot water temperature measured 109.4 degrees Fahrenheit. Disinfectants, cleaning solutions, and poisons were inaccessible to clients. Client room was equipped with the required furnishings. Client bathroom was observed to be sanitary and equipped with the required supplies. Shower/bathtub had nonskid flooring and grab bars. Licensee Andrade provided client with clean linen in good repair, and sufficient hygiene products for personal use. LPA Correia observed smoke alarms, and carbon monoxide detectors throughout the facility that were in operable condition. Per Licensee Andrade there are no weapons and/or ammunition housed in the facility, nor does the facility have any bodies of water on the premises.

The facility is stocked with a 2-day supply of perishable and 7-day supply of nonperishable food items. The food was observed properly stored. Medications are stored in a locked cabinet and administered according to the label instructions. The facility's last disaster drill was conducted on November 1, 2023.

Per staff records reviewed, individuals subject to a criminal record review obtained clearance and/or an exemption; staff responsible for direct care and supervision have current First Aid and CPR training. Administrator certification is current until December 8, 2023.



Based on today's visit, there were no deficiencies observed at this time in the areas evaluated. An exit interview was conducted with Licensee Andrade and will be provided with a copy of this report and licensee/appeal rights (LIC 9058 01/16), and their signature on this form acknowledges receipt of these documents.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2023
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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