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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 09/20/2024
Date Signed: 09/20/2024 12:53:41 PM

Document Has Been Signed on 09/20/2024 12:53 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:CASA DEL SOL RTFFACILITY NUMBER:
374603419
ADMINISTRATOR/
DIRECTOR:		MANUEL VASQUEZFACILITY TYPE:
735
ADDRESS:1561 E MISSION RDTELEPHONE:
(442) 444-8156
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 4CENSUS: 2DATE:
09/20/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:53 AM
MET WITH:Manuel Vazequez, Licensee/AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 09/20/24 at 11:53am, Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a health and safety check. At the time of the visit was one (1) staff and (0) clients present, as they were at the day program.

During today's health and safety check LPA conducted an overall status of the facility.

LPA conducted a tour of the interior and exterior of the facility and observed for the carbon fiber windows in bedroom #1 to have been replaced with glass windows.

LPA obtained copies of the staff schedule. The facility was observed to have operable utilities (gas, water, electricity). The medications were observed to be locked and inaccessible to the clients in care. The MARs were reviewed along with the medications and are being given as prescribed.

The chemicals and hazardous items were observed to be locked and inaccessible to clients in care. The facility was observed to have a 2 day supply of perishable and a 7 day supply of nonperishable food items.

There were no health and safety concerns during today's visit.

An exit interview was conducted, and a copy of this report, was provided to the Licensee/Administrator, Manuel Vasquez.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2024
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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