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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604503
Report Date: 07/16/2024
Date Signed: 07/17/2024 07:40:15 AM

Document Has Been Signed on 07/17/2024 07:40 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
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:MORNINGSIDE MANORFACILITY NUMBER:
374604503
ADMINISTRATOR/
DIRECTOR:
REGINA JACKSON-PATTONFACILITY TYPE:
740
ADDRESS:2847 MORNINGSIDE ST.TELEPHONE:
(619) 856-4968
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY: 6CENSUS: 6DATE:
07/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Regina Jackson-Patton, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced Required Annual Inspection. LPA was welcomed by Nenita Grande, Caregiver to whom LPA identified himself to, and discussed the purpose of the visit. Administrator Regina Jackson-Patton was present. According to the facility’s license, the facility is approved to serve five (5) non-ambulatory and one (1) bedridden residents.

LPA reviewed the CDSS Administrator Certification database and confirmed Ms. Jackson-Patton's Administrator Certificate was current with an expiration date of May 2026.

LPA toured the interior and exterior of the facility and inspected each room. The facility was sanitary, and in good repair. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Hot water temperatures in resident accessible faucets were measured and recorded within approved department range of 105-120 degrees, Fahrenheit. Cooking/dining equipment and utensils were present. Medications were labeled, as required and kept inaccessible to residents.

No bodies of water were observed. Per Ms. Jackson-Patton, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit was complete and accessible. Resident, staff and facility records were reviewed and contained the required documentation. Technical advisories were issued today for storage space and care of bedridden residents. No additional deficiencies were cited on today's visit.

An exit interview was conducted with Administrator Jackson-Patton, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
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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