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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374601445
Report Date: 04/21/2020
Date Signed: 05/28/2020 11:08:18 AM

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:ANGEL'S TOUCH IIFACILITY NUMBER:
374601445
ADMINISTRATOR:LUZ VELASCOFACILITY TYPE:
740
ADDRESS:138 BELLERIVE DRTELEPHONE:
(760) 715-0529
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:6CENSUS: 3DATE:
04/21/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Luz Velasco, AdministratorTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Debbie Correia contacted the facility via telephone to conduct a pre-license inspection to ensure the facility is operating in compliance with California Code of Regulations, Title 22, Division 6. LPA Correia identified herself and discussed the purpose of the virtual visit with Administrator, Luz Velasco.

During today's virtual inspection, LPA toured the facility bedroom (B1) identified for one (1) bedridden and one (1) non-ambulatory resident. Bedroom was observed appropriately furnished and in good repair per Title 22 regulation. The Vista Fire Department granted bedridden fire clearance for B1 on March 11, 2020.

Based on today's visit, no deficiencies were observed in the areas evaluated. An exit interview was conducted with Administrator, Luz Velasco, via telephone and a copy of this report along with Licensee/Appeal Rights (LIC 9058 01/16) was provided to Administrator, Luz Velasco via email. An electronic email read receipt confirms the documents were received.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Debbie CorreiaTELEPHONE: (619) 407-0894
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2020
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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