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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 09/21/2023
Date Signed: 09/21/2023 05:05:52 PM

Document Has Been Signed on 09/21/2023 05:05 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:
09/21/2023
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
03:42 PM
MET WITH:Manuel Vazquez, LicenseeTIME COMPLETED:
05:15 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) Javina George made an unannounced visit at the facility for the purpose of conducting a health and safety check. LPA met with licensee Manuel Vasquez, and explained the purpose of the visit.

At the time of the visit there was (1) staff and (3) client present. LPA observed the facility to be within the required ratio of 3:1. Client # 1 (C1) was at the home in their bedroom looking up coin collections. Client #2 (C2) (is from the Sister facility), was sitting on a bench on the patio in the backyard. Client # 3 (C3) arrived home from the day program, and was observed to have various scratches on their body (legs, thigh, forearm and hand/fingers). LPA observed the medical visit record and C3 was seen by their Primary Care Physician and Psychiatrist on 08/23/23 for the increased scratching, and also has a follow up appointment tomorrow 09/22/23.

LPA conducted a tour of the facility's interior and exterior. While in the garage LPA observed for two tiles in the ceiling, directly above the sink that is next to the washer and dryer, to be laying on the shelf. Licensee Mr. Vazquez explained that the facility had a leak a week ago, as the military base was conducting some testing. The testing caused for the house shake, the shaking moved the tray from under the air conditioning unit. The plumber came out and adjusted the tray. The ceiling is airing out and provide ventilation, to prevent any mold. The air conditioner is operable. The facility was observed to be clean and free of clutter. The facility has (2) rooms that are vacant, and (2) rooms that are occupied.

LPA observed the facility's food supply which met the requirements; 2 day supply of perishable and a 7 day supply of non-perishable food items. LPA observed a sufficient amount of personal protective equipment (PPE) supplies at the facility. LPA observed a sufficient amount of paper supplies (paper towels and toilet paper), for the amount of clients in care.

An exit interview was conducted, and a copy of this report was provided to Licensee, Manuel Vasquez.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2023
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