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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604608
Report Date: 11/17/2022
Date Signed: 11/17/2022 04:01:35 PM


Document Has Been Signed on 11/17/2022 04:01 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:VIBRANT LIVING IIFACILITY NUMBER:
374604608
ADMINISTRATOR:NORRIS, JULIEFACILITY TYPE:
740
ADDRESS:6140 CRAWFORD STREETTELEPHONE:
(619) 929-1730
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:6CENSUS: 0DATE:
11/17/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Applicant Julie NorrisTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Iby Strong, conducted an announced Pre-Licensing inspection. LPA met with Applicant Julie Norris and discussed the purpose of the visit.

LPA conducted a tour of the facility, both inside and outside. The smoke and carbon monoxide alarms were present. Toilets intended for resident use were operating as intended, and bathing facilities were observed to be clean and kempt. The windows, blinds and paint throughout the facility, were observed in good condition. Each room intended for resident use had the appropriate furniture, bedding and appropriate lighting. Administrator stated there are no firearms stored on the premises. Hot water temperature was measured in the facility at 112 degrees F. The ambient temperature inside the facility was measured at 71 degrees F. The facility was observed to be clean and kempt with no strong malodors. The refrigerators and freezers were observed to be clean and operational, with an ample amount of food to meet resident needs. Cleaning solutions were also properly secured in locked storage cabinets.

LPA observed the backyard fencing is now complete. Applicant has also submitted LIC999 directly to LPA.

The Component III portion of the application process was completed with Applicant Julie Norris on today's date as well.

Pre-Licensing is complete and this facility has no deficiencies. An exit interview was conducted. The Applicant will be provided a copy of their Appeal/Licensee rights (LIC9058 03/22) and this report on todays date.
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Iby StrongTELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
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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