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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604721
Report Date: 11/26/2024
Date Signed: 11/26/2024 12:54:35 PM

Document Has Been Signed on 11/26/2024 12:54 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:NESTFACILITY NUMBER:
374604721
ADMINISTRATOR/
DIRECTOR:		AGUIAR, RUBIELAFACILITY TYPE:
735
ADDRESS:1040 MERRITT DRIVETELEPHONE:
(619) 992-3373
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY: 4CENSUS: 0DATE:
11/26/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:06 PM
MET WITH:Rubiela Aguiar, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced Required 1 year Annual Visit. LPA was allowed entry by the Licensee. LPA identified herself and disclosed the purpose of the visit with the Licensee.

Physical Environment:  The facility was clean and free from any safety hazards. Adequate lighting and ventilation were observed in all areas of the facility. All necessary safety equipment, such as fire extinguishers and emergency exits, were present and in good working condition. The facility's outdoor spaces were properly maintained and accessible to residents.

Staffing and Training:  All staff members had completed the required training and certifications per the licensing regulations.  Resident Care and Services:  There were no residents in care. Health and Safety:  Infection control measures were in place. The facility had established protocols for emergencies and evacuation plans were readily available.

Overall, the facility was found to comply with the licensing regulations.  An exit interview was conducted and a copy of this report along with the Licensee Rights (LIC 9058) was provided to the Licensee. Her signature on this form confirms receipt of the documents.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE: DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2024
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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