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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603713
Report Date: 03/19/2021
Date Signed: 03/19/2021 11:41:51 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:PARKVIEW MEMORY CARE AT PARADISE VILLAGEFACILITY NUMBER:
374603713
ADMINISTRATOR:LAWSON, WILLIAMFACILITY TYPE:
740
ADDRESS:735 ARCADIA AVENUETELEPHONE:
(619) 475-5040
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY:70CENSUS: 46DATE:
03/19/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Associate Director, Geovanni AguilarTIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA), Marisela Garcia-Centeno coducted a Tele-Virtual Visit due to COVID-19. LPA identified herself to Associate Director, Geovanni Aguilar, and we discussed the purpose of the visit.

Today's virtual visit is to deliver amended reports to the facility. Amended reports were sent via email to the Associate Director on this date.

No deficiencies were cited or observed on this date.

An exit interview was conducted with Associate Director Aguilar. A copy of this report along with Licensee/Appeal Rights (LIC9058 01/16) was provided to Associate Director Aguilar.
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-CentenoTELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021
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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