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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604416
Report Date: 07/30/2021
Date Signed: 07/30/2021 04:54:15 PM

Document Has Been Signed on 07/30/2021 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:RIGHT CHOICE SENIOR LIVING LLC - LA MESAFACILITY NUMBER:
374604416
ADMINISTRATOR:BROOKS, TODDFACILITY TYPE:
740
ADDRESS:6125 COWLES MOUNTAIN BLVDTELEPHONE:
(619) 439-2294
CITY:LA MESASTATE: CAZIP CODE:
91942
CAPACITY: 6CENSUS: 4DATE:
07/30/2021
TYPE OF VISIT:Case Management - COVID-19ANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Administrator Todd BrooksTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Dang Nguyen conducted an announced Case Management visit, accompanied by nurse contractors Elizar Perez and Sandra Brackman from the Healthcare Acquired Infection (HAI) team of San Diego County Health and Human Services Agency. LPA and HAI nurses were welcomed by, identified themselves to, and discussed the purpose of the visit with Caregiver Marlena Villa. Facility administrator Todd Brooks arrived during the visit.

The Department conducted the on-site visit to provide technical assistance and to evaluate the facility's COVID-19 screening, testing, and disinfection processes and the staff’s use of personal protective equipment. During the visit, LPA and HAI nurses briefly toured the facility, interacted with staff, and interviewed the administrator. No deficiencies were cited on this date.

An exit interview was conducted with Brooks, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail. LPA requested a reply E-mail or read receipt confirmation upon receipt of documents.
SUPERVISORS NAME: Rebecca Hedgecock
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2021
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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