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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 134603872
Report Date: 11/13/2024
Date Signed: 11/13/2024 05:21:13 PM

Document Has Been Signed on 11/13/2024 05:21 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:SUNSET HOMEFACILITY NUMBER:
134603872
ADMINISTRATOR/
DIRECTOR:		MARIA NEGRETEFACILITY TYPE:
735
ADDRESS:1878 SOUTH SECOND STREETTELEPHONE:
(760) 562-6559
CITY:EL CENTROSTATE: CAZIP CODE:
92243
CAPACITY: 4CENSUS: 4DATE:
11/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Maria Negrete AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:02 AM
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Licensing Program Analyst (LPA), Amy Domingo conducted a Case Management visit.  LPA was greeted and allowed entry into the facility by staff, Maria Negrete, Licensee and discussed the purpose of the visit was to follow up on an AWOL incident on 11/8/24.

The Licensee reported that the police was called and the resident that AWOL was located down the street from the facility, within 30 minutes of being reported AWOL. Currently, the resident is at El Centro Regional Hospital. The resident had no injuries.


No deficiencies were observed or cited during today's today.


An exit interview was conducted and a copy of this report was left at the facility. The facility Licensee, Maria Negrete was provided a copy of the licensee rights (LIC 9058 03/22) and their signature on this form acknowledges receipt of these rights.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
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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