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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 10/30/2024
Date Signed: 10/30/2024 07:55:48 AM

Document Has Been Signed on 10/30/2024 07:55 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
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:
10/30/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:01 AM
MET WITH:Juan Pablo, CaregiverTIME VISIT/
INSPECTION COMPLETED:
08:00 AM
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
On 10/30/24 at 07:01am, 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 (2) clients present. The clients were observed to be getting ready for the day, which includes taking their medication and eating breakfast.

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


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 Caregiver Juan Pablo..
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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