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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602869
Report Date: 11/14/2024
Date Signed: 11/14/2024 04:28:39 PM

Document Has Been Signed on 11/14/2024 04:28 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:CEDARS @ PARADISE VILLAGEFACILITY NUMBER:
374602869
ADMINISTRATOR/
DIRECTOR:		WILLIAM LAWSONFACILITY TYPE:
740
ADDRESS:2740 E 4TH STREETTELEPHONE:
(619) 475-5040
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 150CENSUS: 90DATE:
11/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Executive Director Zoe RezaTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Alyssa Ramirez conducted an unannounced Case Management Visit. LPA met with Executive Director Zoe Reza, and we discussed the purpose of the visit.

Today's visit is in response to the self reported AWOL of Resident 1 (R1 - see LIC811 Confidential Names List).

LPA conducted a wellness check at the facility, and no health or safety issues were identified. Facility records were obtained

No deficiencies were cited or observed on this date.

An exit interview was conducted with Health Services Director Julia Meilan . LPA provided a copy of appeal rights (LIC9058 03/22), along with a copy of this report.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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