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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 11/25/2024
Date Signed: 11/25/2024 02:53:10 PM

Document Has Been Signed on 11/25/2024 02:53 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:
11/25/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH:Licensee, Manuel VazquezTIME VISIT/
INSPECTION COMPLETED:
02:55 PM
NARRATIVE
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Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced case management health and safety visit. LPA met with Licensee, Manuel Vazquez, who was informed of the purpose of the visit. At the time of the visit there are (1) staff and (2) clients present. LPA conducted a tour of the interior and exterior of the home and conducted records review.

The physical plant, furniture, and fixtures were present and in good repair. The utilities are on and operating at the time of the visit. LPA observed the outdoor area and exits to be free of hazards. LPA observed the clients in their rooms and common areas of the home. LPA observed the kitchen can prepare food in a clean and safe environment and the food supply was randomly audited. Food was found to be in required numbers and within date.

LPA observed the clients have separate files that are present for inspection. With the assistance of the licensee, the personal and incidental cash was counted and matched the accountability logs. The hazardous items log was reviewed and accounted for. The LIC500 was reviewed which showed adequate staff coverage, and all staff with criminal record clearance.

No immediate health or safety concerned were observed during the time of the visit. No deficiencies were cited at the time of the visit. An exit interview was conducted where this report was reviewed and provided.

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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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