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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 03/17/2025
Date Signed: 03/17/2025 12:03:13 PM

Document Has Been Signed on 03/17/2025 12:03 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:
03/17/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:55 AM
MET WITH:Manuel vazquez, Licensee. AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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On 03/17/25 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 (0) clients present, as they were both at the day program. LPA reviewed the following during today's visit:

Personal and Incidental (P&I) Funds were present and balanced

The food supply log, and hazardous item log

Staff schedule

Client medications were observed to be signed off on the Medication Authorization Record (MAR), and remaining medications were in the bubble pack.

A tour of the interior and exterior was conducted, and was found clean and the passageways were free from obstruction.

The utilities such as gas, water and electric were observed to be operable, and the food supply was observed was adequate.

There were no health or safety concerned were observed during the time of the visit. Additionally no deficiencies were cited during today's 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: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2025
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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