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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604581
Report Date: 10/13/2022
Date Signed: 10/13/2022 01:01:13 PM

Document Has Been Signed on 10/13/2022 01:01 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:BOWEN GUEST HOMEFACILITY NUMBER:
374604581
ADMINISTRATOR:ENGLE, WENDYFACILITY TYPE:
735
ADDRESS:1428 CHRISTINA WAYTELEPHONE:
(760) 440-0116
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY: 4CENSUS: 0DATE:
10/13/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:34 AM
MET WITH:Richard "Rick" Bowen, LicenseeTIME COMPLETED:
11:28 AM
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Licensing Program Analyst (LPA) Esther Miller conducted an announced Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of California Code of Regulations and Health & Safety Code. LPA was met and granted entry by Rick Bowen, Licensee.

The facility fire clearance was granted on August 9, 2022 and reflects that the facility is approved for four (4) ambulatory clients. During today's visit, LPA, accompanied by Licensee, toured the facility inside and outside and inspected every room. The facility was found to be in good repair with no pathway obstructions. Toilets were found to be in working order. Facility temperature was 71 degrees Fahrenheit during the visit. Water temperature in bathrooms measured at 107.8, 105.1, 110.1 degrees Fahrenheit. LPA observed an locked office in which hazardous and/or toxic chemicals will be stored and secured. The office was also a locked room for storage of medications and client and staff records. There is also a first aid kit present in the facility. Activities and sufficient space in which to conduct activities are present. New fire extinguishers were observed in the facility. Smoke and carbon monoxide detectors were recently inspected by the local fire authority, and found to be in working order. No pools or bodies of water were observed near or on the premises. According to the Licensee, no firearms and/or ammunition are present or will be stored in the facility. Ample and appropriate storage was present to store perishable and non-perishable food items. Required postings were observed in a visible area of the facility.

Items reviewed during today's visit are in compliance with Title 22, Division 6 of California Code of Regulations, and Licensee has passed the pre-licensing inspection. Component III was completed during today’s visit. Administrator was advised that the application is pending management final review and approval. Licensee understands that clients cannot move in until this approval is given. A copy of this report and Applicant Rights (LIC9058) were provided to the Licensee.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Esther Miller
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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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