<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603112
Report Date: 03/03/2025
Date Signed: 03/03/2025 10:36:15 AM

Document Has Been Signed on 03/03/2025 10:36 AM - 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:TWAIN RESIDENTIAL CARE, LLCFACILITY NUMBER:
374603112
ADMINISTRATOR/
DIRECTOR:		SIMSUANGCO, LEONARDOFACILITY TYPE:
740
ADDRESS:4626 TWAIN AVETELEPHONE:
(619) 281-8337
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY: 12CENSUS: 10DATE:
03/03/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Chona SimsuangcoTIME VISIT/
INSPECTION COMPLETED:
10:42 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA), Ramon Serrano, conducted an unannounced collateral visit as a follow-up for an unrelated complaint investigation for another facility. LPA was greeted by Caregiver Mila Manansala, LPA discussed the purpose of the visit and Administrator Chona Simsuangco arrived a short while after.

During the visit, LPA interacted with staff and residents and interviewed Administrator.

An exit interview was conducted with Chona Simsuangco and copy of this report along with Licensee Rights (LIC 9058 3/22) was provided to Chona Simsuangco whose signature below verifies receipt of these rights.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1