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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197801131
Report Date: 10/08/2025
Date Signed: 10/08/2025 04:23:45 PM

Document Has Been Signed on 10/08/2025 04:23 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:CASA DEL SOLFACILITY NUMBER:
197801131
ADMINISTRATOR/
DIRECTOR:		LORCA, ANITAFACILITY TYPE:
735
ADDRESS:2312 NORWALK AVENUETELEPHONE:
(323) 258-0151
CITY:LOS ANGELESSTATE: CAZIP CODE:
90041
CAPACITY: 6CENSUS: 4DATE:
10/08/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Co-Adm. Maria Cristina Cuevas, Manager, Valentin Dizon and Felix Paulito Vidal Gastalla, Caregiver TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted a Required One (1) year annual visit and inspection. LPA met with Co- Administrator, Manager, Caregiver who granted entry and explained the reason for the visit.

At 12:25p.m., LPA and manager conducted physical plant tour inside and outside. Required posting observed in facility in the entry area. Smoke alarms and carbon monoxide detectors were tested and found to be operational. The fire extinguisher is in the living room, kitchen and patio fully charged with service tagged date 04/30/2025. During the visit the facility is at 72 degrees Fahrenheit. The facility is fire cleared with six (6) non-ambulatory clients. The facility is a single-story home and has two (02) staff rooms, three (03) client rooms and three (03) bathrooms. There is no body of water in the facility. Disaster, Fire and Earthquake drill was last conducted on 09/28/2025. Clients are attending day program at this time.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (02) days perishable and seven (07) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped, dated, and stored properly as well. Knives and other sharp objects were locked cabinet next to the stove and inaccessible to clients. The menu was posted for review Adult Residential Facility (ARF), snacks and beverages are available for the clients in the facility when they want. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away. Bedrooms: There were three (03) bedrooms designated for clients' use. They were toured and observed to be clean and properly furnished with

Cont. on LIC 809-C

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Antonia Alvizar-Ettima
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: CASA DEL SOL
FACILITY NUMBER: 197801131
VISIT DATE: 10/08/2025
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Cont. from LIC 809

appropriate dresser, bedding, and linens with sufficient lighting. Room #1 and #2 are private rooms. Room #3 is a shared client room. Two (02) bedrooms designated for live-in staff. Bathrooms: There are three (03) bathrooms in the facility. One (01) bathroom designated for clients' use. They were observed to be clean, sanitary and with necessary supplies. Hot water temperature measured at a range of 110.5°F to 116.8°F and within the required range. Bathrooms: There are three (03) bathrooms in the facility. One (01) bathroom designated for clients' use. They were observed to be clean, sanitary and with necessary supplies. Hot water temperature measured at a range of 110.5°F to 116.8°F and within the required range. Client’s personal hygiene supplied are kept in a basket labeled with their name on the bathroom shelf. Towels and washcloths are not shared. The bathrooms were properly supplied and had functional fixtures. Bathroom #2 and bathroom #3 are for staff use only and located inside the staff room and beside bedroom #2 in the hallway. There was enough clean linen available in the cabinets. Common Areas: These include the living room, family room and dining area for clients. The common areas were properly furnished. Furniture in common areas was observed to be in good repair. No obstructions or tripping hazards throughout the facility. Clients dining table fits six (06) clients. Office is located next to the living upon entering the facility. Surrounding Grounds: Entry and exits were free of obstruction. Outdoor area was free from hazards and had appropriate shaded seating. Laundry and storage: Laundry machines were located in the garage and operational. Cleaning agents and detergents were locked and inaccessible to clients. Adequate linens and towels were available. The detached garage is used to storage extra food, Personal Protective Equipment (PPE) supplies, diapers, and gardening tools.

Staff Files: Staff records were reviewed; they all have criminal record clearances and are associated with this facility. Staff have current first aid and training documentation showing training completed. Administrator's certificate was current and posted. Medications: Centrally stored medications were reviewed. Medications were properly labeled and locked in a designated cabinet. No discrepancies were observed in medications administration records (MAR). Over-the-counter and prescription medications had current expiration dates. PRN protocols were properly maintained with physician’s orders. First-aid has all proper items and is current. Client Records All four (04) client records were reviewed. Client records included admission agreement, physician reports and appraisals at this time.

No immediate health and safety hazard is noted during this visit.

Exit interview was conducted, a copy of report was provided to Co-Administrator.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Antonia Alvizar-Ettima
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC809 (FAS) - (06/04)
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