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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604657
Report Date: 02/26/2024
Date Signed: 02/26/2024 08:41:57 PM

Document Has Been Signed on 02/26/2024 08:41 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:REDFIELD HOUSEFACILITY NUMBER:
374604657
ADMINISTRATOR:ARELLANO, TRACIEFACILITY TYPE:
735
ADDRESS:10471 SUSIE PLACETELEPHONE:
(619) 267-0771
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: 4CENSUS: 4DATE:
02/26/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Case Manager Katie OrnettTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Debbie Correia made an unannounced visit to the facility to conduct an annual licensing inspection. LPA identified herself to Case Manager (CM) Katie Ornette and Direct Support Professional (DSP) Peyerre Hart and was granted entry into the facility. Administrator Arrellano arrived a short time later to be present for the inspection. The facility is licensed to serve four (4) clients of whom all four (4) must be ambulatory.

During today’s visit, LPA Correia, accompanied by Administrator Arrellano, toured the interior and exterior of the facility. LPA observed the exterior and interior of the facility to be sanitary and in good repair. LPA observed a First-aid Kit and manual, required postings, shaded area in the backyard, and activities for clients in care. The fire extinguisher was up to date, and smoke alarms and carbon monoxide detectors were present and operable. The facility is licensed to serve four (4) clients of whom all four (4) must be ambulatory. During the facility tour LPA observed pathways were well lit and free of obstruction and slip hazards. All clients had private rooms, allowed for easy passage, that contained all the required furnishings. Toilet and shower were in working order. The facility’s ambient internal temperature was 72 F. Due to clients in care taking showers at the time of today's inspection Administrator Arrellano provided a copy of the daily log of documentation of water temperature checks by facility staff for the month of February. Per Administrator Arellano there are no firearms, weapons, or ammunition on the facility premises. LPA observed no bodies of water on the premises. Client and staff records were present an up to date. LPA observed an adequate supply of PPE, personal hygiene supplies, and observed 2 days of perishable food and 7 days of non-perishable food to meet the clients dietary needs. The facility had an adequate supply of clean linens, PPE, and hygiene supplies.

No deficiencies were cited during today's visit. This report was discussed with Administrator Arrellano. A copy of the report and License Rights (01/2016) will be provided at the conclusion of the visit, and signature on this form acknowledges receipt of the rights and a copy of this report.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: REDFIELD HOUSE
FACILITY NUMBER: 374604657
VISIT DATE: 02/20/2024
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The facility has enough linens, hygiene supplies, dining supplies, and perishable and non-perishable food for future client use. The refrigerator unit inside the kitchen was 37 F, and the refrigerator unit in the garage was 35 F. The freezer unit inside the kitchen was -2 F, and the freezer unit inside the garage was 0 F. The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and client activities. The facility has locked areas for storage of medication and confidential client and staff records. No pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Per the applicant, no firearms or ammunition are or will be stored at the facility.Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. Two (2) fire extinguishers and one (1) first aid kit were present. Required licensing postings were observed in visible areas of the facility
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No deficiencies cited at today's visit. This report was discussed with Licensee Brooks, who joined the inspection at a later time. A copy of the report and License Rights (01/2016) will be provided at the conclusion of the visit, and signature on this form acknowledges receipt of the rights and a copy of this report.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024
LIC809 (FAS) - (06/04)
Page: 1 of 1