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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604678
Report Date: 11/14/2024
Date Signed: 11/14/2024 11:05:18 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/14/2024 11:05 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:HILLTOP HOME CARE CENTER IIFACILITY NUMBER:
374604678
ADMINISTRATOR/
DIRECTOR:
JANE ARLYN H. ANTONIOFACILITY TYPE:
735
ADDRESS:3232 KEMPF STREETTELEPHONE:
(619) 777-3746
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY: 4CENSUS: 0DATE:
11/14/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Administrator Jane and Gil AntonioTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Amy Rodgers and Angelica Boyles conducted an unannounced visit to conduct a Required Annual Inspection. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator Jane Antonio.

During today’s inspection, there were zero (0) clients, Administrator explained facility has not had any clients in care since opening. During today’s visit, LPAs, accompanied by the Administrator, toured the interior and exterior of the facility, and inspected all common areas and resident bedrooms and bathrooms. Although there are no clients in care, the facility is not ready to accept clients at this time due to outside renovations.

Inside the facility was clean, sanitary, and in good repair. Inside pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. The facility had sufficient space and equipment to facilitate dining, visitation, meetings, and client activities. The facility’s ambient internal temperature was complaint. Hot water temperature at taps accessible to clients were complaint. At the time of the visit there were at least (2) days of perishable food and at least seven (7) days non-perishable food present, all safely stored. Smoke detectors, carbon monoxide detectors, emergency lighting, night lights, and facility telephone were all working. The facility’s fire extinguisher was serviced within the last twelve (12) months. Required licensing postings were observed in visible areas of the facility. Licensee presented proof of current business liability insurance.

An exit interview was conducted with Administrator Jane Antonio. A copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during today's visit

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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