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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604704
Report Date: 09/11/2024
Date Signed: 09/11/2024 12:48:27 PM

Document Has Been Signed on 09/11/2024 12:48 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:CROWNVIEW PSYCHIATRIC INSTITUTE INC.FACILITY NUMBER:
374604704
ADMINISTRATOR/
DIRECTOR:
MICHELLE ERTELFACILITY TYPE:
772
ADDRESS:1114 VISTA WAYTELEPHONE:
(760) 557-9894
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY: 6CENSUS: 5DATE:
09/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Administrator Michelle ErtelTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Michelle Ertel. According to the facility’s license, the facility has a maximum capacity of six (6) clients of whom all must be ambulatory.

LPA toured the interior and exterior of the facility and inspected each room. This is a two building property. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

Cooking/dining equipment and utensils were present. Medications were labeled, as required, and stored in locked areas. Water temperature was measured at 107 degrees F, ambient room temperature was 72 degrees F.



No pool or body of water present. Per Michelle, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible.

Client records reviewed contained the required documentation. Staff records reviewed contained required documentation. There were no sharp objects or toxic chemicals accessible to clients.



An exit interview was conducted with Administrator to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE: DATE: 09/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2024
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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