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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604713
Report Date: 10/14/2024
Date Signed: 10/14/2024 03:26:36 PM

Document Has Been Signed on 10/14/2024 03:26 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:LORENZO'S LIGHTHOUSE IIFACILITY NUMBER:
374604713
ADMINISTRATOR/
DIRECTOR:		MALVEDA, ABBY NFACILITY TYPE:
735
ADDRESS:7815 MOUNT VERNON ST.TELEPHONE:
(916) 835-3979
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY: 6CENSUS: 4DATE:
10/14/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:35 AM
MET WITH:Licensee/Administrator Maricon GeronimoTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Required Annual Inspection to ensure substantial compliance with Title 22 regulations. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with facility Licensee/Administrator Maricon Geronimo.

LPA briefly toured the facility, reviewed personal records and client records . There were no immediate health and safety concerns observed during the visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection.

An exit interview was conducted with Licensee/Administrator Maricon Geronimo A copy of this report and Licensee Appeal Rights (LIC 9058 03/22) were provided to Licensee/Administrator Maricon Geronimo at the conclusion of the visit.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2024
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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