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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602806
Report Date: 03/21/2024
Date Signed: 03/21/2024 12:25:53 PM


Document Has Been Signed on 03/21/2024 12:25 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:HOME SWEET HOME CAREFACILITY NUMBER:
374602806
ADMINISTRATOR:NONAY, NORMA D.FACILITY TYPE:
740
ADDRESS:6811 FUJI STREETTELEPHONE:
(619) 472-9205
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY:6CENSUS: 2DATE:
03/21/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:59 AM
MET WITH:Norma Nonay, LicenseeTIME COMPLETED:
12:30 PM
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Licensing Program Analysts (LPAs) Dawn Segura and Adrian Mangina conducted an unannounced case management visit to clear a Plan of Correction. LPAs identified themselves, were granted entry into the facility, and met with Norma Nonay, Licensee, to whom LPA Segura disclosed the purpose of the visit.

LPA Segura previously conducted a required annual inspection visit at the facility on 03/14/2024. On that date, a Type B deficiency was cited. On today's date, LPA Segura verified that the carbon monoxide detector was functioning. The deficiency previously cited under section 1569.311 of the Health and Safety Code is being cleared as having been corrected.

An exit interview was conducted with Norma Nonay, Licensee to whom copies of this report and Licensee/Appeal Rights (LIC9058 03/22) were provided at the end of the visit.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn SeguraTELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2024
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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