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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602991
Report Date: 03/07/2024
Date Signed: 03/07/2024 03:45:37 PM


Document Has Been Signed on 03/07/2024 03:45 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:VERDUGO BOARDING HOMEFACILITY NUMBER:
374602991
ADMINISTRATOR:JACOME, RIGOBERTO GARCIAFACILITY TYPE:
740
ADDRESS:690 HELEN DRIVETELEPHONE:
(760) 757-8403
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:6CENSUS: DATE:
03/07/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Licensee Rigoberto GarciaTIME COMPLETED:
03:45 PM
NARRATIVE
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Assistant Program Administrator (APA) Icela Estrada, Licensing Program Manager (LPM) Jennifer Lott, and Licensing Program Analyst (LPA) Rebecca Ruiz conducted an Office Meeting and met with Licensee Rigoberto Garcia to discuss the Department's inspection authority.

During today's meeting, APA Estrada and Mr. Garcia discussed the Department's inspection authority regarding the facility records and admission agreements. APA Estrada reviewed regulations 87208 Plan of Operations and 87506(d), as well as Health and Safety Code 1569.269(a)(3) and provided Mr. Garcia with copies of the regulations and Health and Safety Code. APA Estrada advised that during future licensing visits, LPAs will remove facility records from the facility for review purposes to prevent resident distress. APA Estrada discussed referring Mr. Garcia to County of San Diego Mental Health for collaboration. APA Estrada advised that the Plan of Operation which includes the Admission Agreement needs to be updated and approved by the Department.

This report was discussed with Mr. Garcia. A copy of this report, along with Appeal Rights, were provided to Mr. Garcia at the conclusion of the visit.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A RuizTELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2024
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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