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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 09/26/2022
Date Signed: 09/26/2022 02:09:29 PM

Document Has Been Signed on 09/26/2022 02:09 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, 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: 2DATE:
09/26/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Manuel Vasquez, AdministratorTIME COMPLETED:
02:15 PM
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), Stephanie Torres, made an unannounced visit to the facility to conduct a health and safety visit. The LPA met with Manuel Vasquez, Administrator, and informed him of the purpose of her visit.

At the time of the visit there was (1) staff and (3) clients present. LPA observed the facility to be within the required ratio of 3:1. LPA conducted a tour of the facilities interior and exterior. LPA walked through back yard, garage, kitchen, living room, activity room, and clients bedrooms and bathrooms. The facility has (4) bedrooms and (2) bathrooms. The facility was observed to be clean and free of clutter. Two (2) clients present at the facility were visiting from another residential facility.

LPA observed the facility's food supply which met the required 2 day supply of perishable and 7 day supply of non-perishable supply. LPA observed a sufficient amount of PPE supplies at the facility.

No citations were issued, and no health and safety concerns were observed at the time of the visit. This report was reviewed with Administrator, Manuel Vazquez, and a copy was provided.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Stephanie Torres
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2022
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