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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604879
Report Date: 01/13/2025
Date Signed: 02/19/2025 09:40:29 AM

Document Has Been Signed on 02/19/2025 09:40 AM - 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:CHANGING OPTIONS - H STREETFACILITY NUMBER:
374604879
ADMINISTRATOR/
DIRECTOR:		HURTADO, RACHAELFACILITY TYPE:
735
ADDRESS:163 H STREETTELEPHONE:
(760) 789-7299
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY: 6CENSUS: 0DATE:
01/13/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Operations Manager, Jennie AlshouseTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA), David Roman conducted a Pre-Licensing inspection. An initial application to operate an Adult Residential Care Facility was completed on 11/30/24. The facility was approved to care for six (6) Ambulatory Residents. LPA was greeted and allowed entry into the facility by Operations Manager, Jennie Alshouse. LPA met with Jennie Alshouse, Cameron McCabe, and Robert Satterfield.

The facility is a single story structure with 4 bedrooms and 2 bathrooms. There is an outdoor covered area for resident use. Outdoor hot tub identified in facility sketch as a body of water (covered and locked) were observed. Rooms #1-#4 may be used for ambulatory residents. No bedroom for staff. All bathrooms have a functioning toilet, sink, grab bars and tub/shower with non-skid mats. The house has adequate supply of linens, towels, hygienic products, food, and cleaning products. Fire clearance was approved on 12/02/24.

Emergency exit facility sketch plan and required postings present (missing menus). Smoke detectors and carbon monoxide detectors- interconnected and hardwired. Home appliances, stove burners, oven, microwave, washer, and dryer working. Cleaning chemicals are stored in a locked cabinet. Water temperature measured at 120 degrees F. Medications are to be centrally stored and locked in a closet. First-Aid Kit accessible in the kitchen area. Resident files will be located in front locked closet. Staff files maintained centrally stored at corporate office and made readily available upon request. Resident activities consist of adequate supplies to include books, exercising, painting, and puzzles for resident's use.

LPA D. Roman completed the Pre-Licensing inspection visit. Information provided about how to operate the facility within substantial compliance. All items reviewed during the visit are in compliance. Pre-licensing is complete and this facility has no deficiencies. Facility appears to be ready for licensor pending final review.

An exit interview was conducted and a copy of this report was provided to Operations Manager, Jennie Alshouse signature below confirms receipt of this report and rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2025
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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