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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604783
Report Date: 07/23/2024
Date Signed: 07/23/2024 04:54:43 PM

Document Has Been Signed on 07/23/2024 04:54 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:JANNA RESIDENTIALFACILITY NUMBER:
374604783
ADMINISTRATOR/
DIRECTOR:
PHILLIPS, ARIANEFACILITY TYPE:
735
ADDRESS:1144 ST GEORGE DRTELEPHONE:
(619) 736-7115
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY: 3CENSUS: 0DATE:
07/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Administrator Ariane PhillipsTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Iby Strong, conducted an announced Pre-Licensing inspection. LPA met with Administrator Ariane Phillips and discussed the purpose of the visit.

LPA conducted a tour of the facility, both inside and outside. During todays visit LPA observed a fence limiting access to the open bank on the property. Additionally, the walls and floors were complete.

The smoke and carbon monoxide alarms were present. Toilets intended for client use were operating as intended, and bathing facilities were observed to be clean and kempt. The windows, blinds and paint throughout the facility, were observed in good condition. Each room intended for client use had the appropriate furniture, bedding and appropriate lighting. Administrator stated there are no firearms stored on the premises.

Hot water temperature was measured in the facility at 120 degrees F. The ambient temperature inside the facility was measured at 77 degrees F. The facility was observed to be clean and kempt with no strong malodors. The refrigerators and freezers were observed to be clean and operational, with an ample amount of food to meet clients needs. Cleaning solutions were also properly secured. Medications were locked in medication box.


The Component III portion of the application process was completed with Administrator Ariane Phillips.

Pre-Licensing is complete and this facility has no deficiencies. An exit interview was conducted. The Applicant will be provided a copy of their Appeal/Licensee rights (LIC9058 3/22) and this report on todays date.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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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