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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603349
Report Date: 04/11/2023
Date Signed: 04/11/2023 09:58:06 AM


Document Has Been Signed on 04/11/2023 09:58 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:VISTA VILLAGE CAREFACILITY NUMBER:
374603349
ADMINISTRATOR:SMILJA MILOSAVLJEVICFACILITY TYPE:
740
ADDRESS:222 WASHINGTON STREETTELEPHONE:
(760) 295-7258
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:12CENSUS: 10DATE:
04/11/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Administrator Dobrilla Milosavjevic and Licensee Miliana MilosavljevicTIME COMPLETED:
10:00 AM
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On today's date an informal meeting was held with Licensing Program Analyst (LPA) Javina George and Licensing Program Manager (LPM) Joel Esquivel met with the Administrator Dobrilla Milosavjevic and Miliana Milosavljevic, issues discussed were:

- substantiated complaint findings

Licensee and administrator provided a reasonable response to the substantiated complaint.

A review of available resources were provided such as:
- contacting the local Ombudsman, Adult Protective Service Agency (APS), and CCL Duty officer.

During todays meeting LPM made an offer to make a referral for the Technical Support Program (TSP). At this time both the Administrator and Licensee decided to hold off on utilizing the TSP, however they are aware of the resource that is available.

The Administrator Dobrilla and Licensee Miliana were receptive to the feedback and resources provided.

An exit interview was conducted and a copy of this report was reviewed and provided to Administrator Dobrilla Milosavjevic and Licensee Miliana Milosavljevic.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina GeorgeTELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2023
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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