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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604598
Report Date: 01/23/2024
Date Signed: 01/23/2024 08:59:15 PM

Document Has Been Signed on 01/23/2024 08:59 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:ROCK ACRE RANCHFACILITY NUMBER:
374604598
ADMINISTRATOR:ALVAREZ, CHRISTYFACILITY TYPE:
735
ADDRESS:9281 ROCK ACRE DR.TELEPHONE:
(619) 750-7663
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 4CENSUS: 4DATE:
01/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:House Manager Raenisha HolmesTIME COMPLETED:
04:45 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 House Manager Holmes, identified herself, was granted entry into the facility, and stated the purpose of today’s visit. There were three (3) clients, and three (3) staff present during today's visit. LPA Correia conducted a general overall inspection. The facility is licensed to serve 4 clients, ages 18 to 59, all of whom are ambulatory. The facility Administrator, Christy Alvarez, arrived at the facility to attend the inspection.

LPA, accompanied by Administrator Alvarez, conducted a facility tour. The facility temperature was 72 degrees Fahrenheit at the time of the visit. The hot water temperature, measured at 110- and 109-degrees Fahrenheit. Disinfectants, cleaning solutions, and poisons were inaccessible to clients. Client rooms were equipped with the required furnishings. Client bedrooms were observed to be sanitary and equipped with the required supplies. Shower/bathtub had nonskid flooring and grab bars. Facility staff provided clients 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 Administrator Alvarez, 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 December 14, 2023. Per staff records reviewed, individuals subject to a criminal record review obtained clearance; staff responsible for direct care and supervision have current First Aid and CPR training. Administrator certification was also current.

Based on today's visit, there were no deficiencies observed at this time in the areas evaluated. An exit interview was conducted and a copy of this report will be provided to Administrator Alvarez. Signature confirms receipt of the document

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2024
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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