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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604713
Report Date: 10/25/2024
Date Signed: 10/25/2024 03:19:39 PM

Document Has Been Signed on 10/25/2024 03:19 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:
10/25/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Licensee/Administrator Maricon GeronimoTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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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.

According to the facility’s license, the facility serves six (6) developmentally disabled, ambulatory clients, age range 18 through 59. On the day of the visit, LPA observed three (3) client, as the others were out in the community.

During the inspection, LPA toured the interior and exterior of the facility and observed each client’s room. The facility was organized, kept and in good repair. The facility had no offensive odors. Pathways inside the property were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

There were at least two days of perishable food, and at least seven days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. Medications were labeled, as required, and stored in locked areas.

[Continuation 9099]
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
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 2
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: LORENZO'S LIGHTHOUSE II
FACILITY NUMBER: 374604713
VISIT DATE: 10/25/2024
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[Continuation 9099]

No pools or bodies of water were observed on the premises. Per licensee Geronimo, no firearms or ammunition are kept at the facility. Emergency lighting, and facility telephone were all working. LPA observed carbon monoxide, smoke detectors, and fire extinguishers and all were serviceable and operational. First aid kit(s) were observed. Required licensing postings were observed in visible areas of the facility. Hot water temperatures measured are compliant in faucets accessible to clients. Bathroom toilets, sinks and showers were observed to be in good service and operational.

LPA interviewed clients and reviewed staff and client records/files. Staff records contained CPR/First Aid certifications, health screenings and fingerprint clearances. LPA reviewed client files which contained the required documents and were maintained in a secure area in the facility. No deficiencies were cited during today's annual inspection.

An exit interview was conducted with Licensee, Geronimo, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC809 (FAS) - (06/04)
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