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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604651
Report Date: 03/04/2025
Date Signed: 03/04/2025 10:10:13 AM

Document Has Been Signed on 03/04/2025 10:10 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:HOPE INC IVFACILITY NUMBER:
374604651
ADMINISTRATOR/
DIRECTOR:		CAMACHO JR, ARTUROFACILITY TYPE:
775
ADDRESS:8125 BROADWAYTELEPHONE:
(619) 933-3077
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY: 60CENSUS: 11DATE:
03/04/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Site Coordinator Richard Covarrubias and Assistant
Director Cynthia Vasquez 		TIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Site Coordinator Richard Covarrubias and Assistant Director (AD) Cynthia Vasquez.

According to the facility’s license, facility serves sixty (60) ambulatory adults, ages 18 and over. The facility does not feature a secured perimeter or delayed egress doors.

LPA, accompanied by Coordinator Covarrubias and Assistant Director Vasquez, toured the interior and exterior of the day program facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Doors, windows and screens, sinks, and toilets were in working order. Hand hygiene supplies and Personal Protective Equipment were present. The facility’s ambient internal temperature was comfortable and compliant, reading at 70F. Hot water temperature at taps accessible to consumers  were also compliant. Hot water at bathroom tap read to be at 107F. There are Four (4) bathrooms in the facility. LPA observed areas that are available for privacy such as changing.

The facility can provide snacks as needed however, participants usually bring their own snacks and lunch. The facility had sufficient space and equipment to facilitate meetings and client activities including arts, crafts, exercise, computers and community outreach programs.

[Continued on LIC809-C]  
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: HOPE INC IV
FACILITY NUMBER: 374604651
VISIT DATE: 03/04/2025
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[Continued from LIC 809]

There were no sharp objects or toxic chemicals/poisons accessible to clients. No pools or bodies of water were observed on the premises. All fire and carbon monoxide detectors are working. Emergency lighting, and facility telephone were all working. Fire extinguishers were operable, and the last fire drill was completed on January 31st, 2025. First aid kits were complete and readily accessible. Per AD Vasquez, nor firearms or ammunition are kept on the premises.

LPA was able to interview (2) staff and observe consumers. LPA interviews did not raise any licensing concerns. LPA also reviewed multiple staff and consumers records/files. Files reviewed contained required documents. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility. LPA observed consumers were being treated with dignity by staff, and there were sufficient staff on duty to meet consumers’ needs.

Based on today's inspection there are no deficiencies observed at this time in the areas evaluated. An exit interview was conducted with Assistant Director Cynthia Vasquez, to whom a copy of this report was provided. Their signature below confirms receipt of this document.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
LIC809 (FAS) - (06/04)
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