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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603852
Report Date: 11/22/2021
Date Signed: 11/22/2021 11:50:38 AM

Document Has Been Signed on 11/22/2021 11:50 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SUNVIEW GARDENSFACILITY NUMBER:
374603852
ADMINISTRATOR:ARCANGELI, FELICITYFACILITY TYPE:
740
ADDRESS:14227 MIDLAND RDTELEPHONE:
(858) 342-9431
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 6CENSUS: 0DATE:
11/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Felicity Arcangeli, AdministratorTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Iriarte-Rendon conducted an unannounced annual required inspection on today's date. LPA was greeted at the front door by Tony Arcangeli, Licensee, and granted entry after identifying herself and disclosing the purpose of the visit. An overall tour of the facility was conducted. Felicity Arcangeli, Administrator, arrived later during the tour. The inspection included, but was not limited to, verifying compliance with statutes, regulations and other requirements most relevant to protecting the health of residents in care and staff, including in the area of infection control practices. Licensee informed LPA that facility has not had a resident since June 2020 due to the pandemic and because remodeling plans were in process. As of today, remodeling has been completed and Administrator plans to reintroduce residents into the facility as soon as a new facility sketch is submitted to Community Care Licensing and approved.

LPA reviewed with Administrator the facility’s Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report (LIC808) including the following sections: Persons in Care, Staff, Visitors, Facilities without COVID-19, Residents, Facility Plans for Infection Control, and Physical Distancing. LPA assessed the strategies that the facility is employing for the prevention, containment and mitigation of COVID-19, implementation of infection control guidance, staff retention and essential health and safety.

LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy, and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE (Personal Protective Equipment). Based on observations, the facility is in compliance with and has implemented infection control practices as outlined in its LIC808.

No deficiencies were observed during today's visit. An exit interview was conducted with Administrator and a copy of this report along with Licensee/Appeal Rights (LIC9058 FAS 01/16) was provided via email; facility representative expressed that they would send LPA a confirmation email upon receipt of these documents.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Esther Iriarte-Rendon
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2021
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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