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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603419
Report Date: 03/30/2022
Date Signed: 03/30/2022 06:13:22 PM

Document Has Been Signed on 03/30/2022 06:13 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:CASA DEL SOL RTFFACILITY NUMBER:
374603419
ADMINISTRATOR:MANUEL VASQUEZFACILITY TYPE:
735
ADDRESS:1561 E MISSION RDTELEPHONE:
(619) 405-7750
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 4CENSUS: 4DATE:
03/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Manuel Vazquez, Martha Lamadrid, LicenseeTIME COMPLETED:
06:20 PM
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On 3/30/22 Licensing Program Analyst (LPA) Javina George and Investigator Wilfredo Vazquez conducted a health and safety check. LPA was greeted and granted entry by Martha Lamadrid, Licensee. LPA met with both licensee's Manuel and Martha Lamadrid and explained the purpose of the visit. At the time of the visit there were three (3) staff and four (4) clients present.

LPA conducted a tour of the interior and exterior of the facility. The facility was clean and clutter free. LPA observed the facility to have the required of food, 2 day supply of perishable and a 7 day supply of non-perishable food items.

All four (4) clients were present and were groomed and were watching TV. The facility has an adequate supply of hygiene items and have the required covid postings. Client files were reviewed. No health and safety concerns were observed.

An exit interview was conducted and a copy of this report was provided to licensee's Manuel and Martha Lamadrid.


SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2022
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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