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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 02/25/2025
Date Signed: 02/25/2025 03:16:25 PM

Document Has Been Signed on 02/25/2025 03:16 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:
02/25/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:02 PM
MET WITH:Manuel Vasquez, Licensee/Administrator TIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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On 02/25/25 Licensing Program Analyst (LPA) Javina George made an unannounced case management health and safety checks visit. LPA met with Licensee, Manuel Vasquez, and informed him of the purpose today's 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 of the following: food supply log (ensures expired food items are being discarded), hazardous items log, and staff schedule.

The utilities such as gas, water and electric were observed to be operable. LPA observed the exterior areas to be manicured and the exits to be free from obstruction. The facility food supply was adequate as there was a 2 day supply of perishables and a 7 day supply of non perishable food items.

With the assistance of the licensee, LPA reviewed both client #1 (C1) and client #2 (C2) P&I funds. LPA observed for the amount indicated on the client safeguards for cash resource log to match the amount in the black pouch, plastic sandwich bag and envelope. In addition LPA observed for the hazardous items log that was implemented in October 2024 to be updated to reflect that the checks are being conducted for both C1 and C2. The logs are posted on a clipboard directly outside of the assigned client bedrooms.

LPA obtained and reviewed the staff schedule which showed adequate staff coverage. The medications were observed to be signed off on the Medication Authorization Record (MAR), and remaining medications were in the bubble pack.

There were no 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 to Licensee/Administrator Manuel Vasquez.

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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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