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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600188
Report Date: 01/10/2023
Date Signed: 01/10/2023 01:50:00 PM

Document Has Been Signed on 01/10/2023 01:50 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:AQUINO'S QUALITY HOMECAREFACILITY NUMBER:
374600188
ADMINISTRATOR:FELICIDAD M. AQUINOFACILITY TYPE:
735
ADDRESS:598 IVY COURTTELEPHONE:
(619) 482-6897
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 6CENSUS: 5DATE:
01/10/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:21 PM
MET WITH:Caregiver, Eufrosina HernandezTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Elizabeth Hamilton conducted a case management visit to give a technical violation identified while at the facility for an unrelated visit. LPA Hamilton was greeted at the front entrance by Caregiver, Eufrosina Hernandez and granted entry after identifying herself. Licensee, Bernardo Aquino arrived during the visit. LPA explained the purpose of the Case Management.

On January 10, 2023, while LPA Hamilton was at the facility LPA observed food products stored in the same area as cleaning compounds.

A technical violation was given Per Title 22, Division 6, Chapter 8 of the California Code of Regulations (see LIC9102). An exit interview was conducted with Licensee, to whom a copy of this report and the Licensee appeal Rights (LIC9058) were provided.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2023
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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