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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604725
Report Date: 02/27/2024
Date Signed: 02/27/2024 12:28:49 PM

Document Has Been Signed on 02/27/2024 12:28 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:CHANGING OPTIONS ADULT DAY CAREFACILITY NUMBER:
374604725
ADMINISTRATOR:MELCHER, JENNIFERFACILITY TYPE:
775
ADDRESS:500 3RD STREETTELEPHONE:
(714) 224-0826
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY: 21CENSUS: 14DATE:
02/27/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Applicant's Representative, Jennifer MelcherTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Dang Nguyen conducted an announced Pre-Licensing visit to observe the day program’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted by, identified himself to, and explained the purpose of the visit to the applicant’s representative, Jennifer Melcher.

The facility fire clearance was granted on 10/03/2023 and reflected that the day program facility was approved for twenty-one (21) clients in total, of which all must be ambulatory. The fire clearance did not include endorsements for delayed-egress doors or secured perimeter, and neither were present during today's visit. The submitted facility sketch was consistent with the current layout of the facility.



During today’s visit, LPA, accompanied by the applicant’s representative, toured the interior and exterior of the day program facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Toilets and sinks were in working order. The facility’s ambient internal temperature was complaint at 72 degrees F. Hot water temperature at taps accessible to clients were also compliant: Bathroom #1 sink was 111.7 F, Bathroom #2 sink was 111.6 F, Bathroom #3 sink was 108.9 F, Bathroom #4 sink was 117 F, and Bathroom #5 sink was 105 F.

The day program facility has enough food for future client use. All kitchen appliances were in working order. Kitchen Refrigerator temperatures were 40 F and 40 F, respectively. Medication Refrigerator was 40 F. Kitchen Freezer temperatures were -12 F and -13 F, respectively. Overflow Freezer temperature was 0 F.


[CONTINUED ON LIC 809-C]
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: CHANGING OPTIONS ADULT DAY CARE
FACILITY NUMBER: 374604725
VISIT DATE: 02/27/2024
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[CONTINUED FROM LIC 809]

The facility has sufficient space and equipment to facilitate visitation, meetings, and client activities. The facility has locked areas for storage of sharp objects, medication, and confidential client and staff records.

The facility's swimming pool was secured behind a fence with locking gates which meet regulatory requirements. There were no toxic chemicals/poisons, non-screened fireplaces, or open-faced heaters accessible to clients. Per the applicant’s representative, no firearms or ammunition are or will be stored at the facility.

Smoke alarms, carbon monoxide detector, emergency lighting, and facility telephone were all operational. All fire extinguishers were serviced within the last twelve (12) months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility.

The items reviewed were complaint with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. The applicant passed the pre-licensing inspection.

LPA also provided the Component III Training during today’s visit. Melcher was advised that the facility’s application is pending management final review and approval.

An exit interview was conducted with the applicant’s representative, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
LIC809 (FAS) - (06/04)
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