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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604545
Report Date: 03/07/2025
Date Signed: 03/07/2025 06:40:56 PM

Document Has Been Signed on 03/07/2025 06:40 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:GARDENS AT ESCONDIDOFACILITY NUMBER:
374604545
ADMINISTRATOR/
DIRECTOR:		SCOTT-KAPILOFF, ANGELAFACILITY TYPE:
740
ADDRESS:1342 NORTH ESCONDIDO BLVDTELEPHONE:
(760) 480-8155
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 101CENSUS: 68DATE:
03/07/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
05:00 PM
MET WITH:Resident Services Director Nae BrownellTIME VISIT/
INSPECTION COMPLETED:
06:50 PM
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Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Case Management Visit.  LPA was greeted by and met with Resident Services Director Nae Brownell, to discuss the purpose of the visit. 

Today's visit is in response to two self-reported incidents submitted by the facility regarding a resident death and a resident who with a medical condition who is no longer able to meet their own insulin needs.

LPA conducted a wellness check at the facility; no health or safety issues were identified. No deficiencies were cited or observed on this date. 

An exit interview was conducted with Resident Services Director Nae Brownell, who was provided with a copy of this report and Appeal Rights (LIC9056 03/22). Their signature confirms receipt of these documents.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2025
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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