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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 07/20/2022
Date Signed: 07/20/2022 10:48:16 AM

Document Has Been Signed on 07/20/2022 10:48 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:CASA DEL SOL RTFFACILITY NUMBER:
374603419
ADMINISTRATOR:MANUEL VASQUEZFACILITY TYPE:
735
ADDRESS:1561 E MISSION RDTELEPHONE:
(442) 444-8156
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 4CENSUS: 3DATE:
07/20/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Licensee, Manuel VazquezTIME COMPLETED:
10:55 AM
NARRATIVE
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Licensing Program Analyst (LPA) Janira Arreola, made an unannounced visit to the facility for the purpose of a health and saftey check. LPA was greeted and granted entry by Licensee, Manuel Vasquez, who was informed of the purpose of the visit.

At the time of the visit, there were (1) staff and (3) clients present. LPA observed the facility to be within the required ratio of 1:3. LPA proceeded to tour the interior and exterior of the home. LPA toured the kitchen and observed the facilities perishable and non-perishable food supply. LPA observed the food supply to be within the required 2-day and 7-day requirement respectively. LPA observed client medication that was kept locked and centrally stored. LPA observed a 30-day supply of client medication for C1 and C2. LPA observed the facilities PPE supply, which was a sufficent 30-day supply. Paper supply at the facility was also observed such as toilet paper, and paper towels.

LPA observed C1 in their room resting on their bed, C2 was not at the facility at the time of the visit, per Licensee C2 was at their day program. C3 and C4 were at the facility from Casa Del Sol RTF II due to the client's day program being closed. C3 was observed at the facility in the living area. C4 was observed to be sleeping.

No deficiencies or health and safety issues were observed or issued during the time of the visit. An exit interview was conducted with Licensee, Manuel Vasquez where this report was reviewed. A copy of this report was provided to facility licensee.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2022
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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