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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603759
Report Date: 06/01/2023
Date Signed: 06/01/2023 01:13:00 PM


Document Has Been Signed on 06/01/2023 01:13 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:DAYBREAK VILLA EASTFACILITY NUMBER:
374603759
ADMINISTRATOR:CORPUZ, ROLANDOFACILITY TYPE:
740
ADDRESS:1682 DAYBREAK PLACETELEPHONE:
(760) 781-1079
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY:6CENSUS: 6DATE:
06/01/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Licensee Represntative, Bin ShenTIME COMPLETED:
11:08 AM
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Licensing Program Analyst (LPA) Janira Arreola conducted an informal office meeting with managing member of Twet LLC, Bin Shen. The meeting was accorded to speak about topics of concern with Daybreak Villa East and Daybreak Villa West (374603760).
  • Provide updated Articles of Incoproration and LIC309 for managing LLC's of the facility: Twet LLC, GODM Investmentsa, Shnaghai Nushi
  • LPA provided consultation to Shen, as they expressed they are looking at a potential buyer for Daybreak Villa West and Daybreak Villa East. Shen was informed of liability of the licensee, and proper notification that is needed to the resident responsible parties and to the department
  • Administration of the facility, and Administrator hours to 20 hours per week at each facility, Daybreak Villa West and Daybreak Villa East
  • Use of restraints on residents in care, Shen agreed would cease immediately and facility would provide the requested documentation by the POC due dates.


The facility is to provide the requested Licensee documentation by June 6, 2023 close of business 5 p.m.

An exit interview was conduced where this report was reviewed and provided to the Licensee representative, Bin Shen through email for signature.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira ArreolaTELEPHONE: 951-248-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/01/2023
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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