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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603778
Report Date: 05/18/2023
Date Signed: 05/18/2023 02:23:23 PM


Document Has Been Signed on 05/18/2023 02:23 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:HERITAGE HILLSFACILITY NUMBER:
374603778
ADMINISTRATOR:STEFANIE ANCHETAFACILITY TYPE:
740
ADDRESS:2108 EL CAMINO REALTELEPHONE:
(760) 206-7930
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:74CENSUS: 69DATE:
05/18/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Executive Director Stefanie AnchetaTIME COMPLETED:
02:25 PM
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Licensing Program Analyst (LPA) Rebecca Ruiz conducted a plan of correction visit. LPA was greeted by, identified herself to, and explained the purpose of the visit to Resident Services Director Yessenia Reyes. Executive Director Stefanie Ancheta arrived during the visit.

The purpose of the visit was to verify if the deficiency issued on 4/25/2023 had been corrected. On 4/25/2023, the licensee was issued a deficiency with a correction due date of 5/05/2023. As of today’s date, 5/18/23, the licensee has not submitted proof of correction to the Department.

During today’s visit, LPA Ruiz verified that the licensee corrected the deficiency regarding reporting requirements and submitting incident reports via email on 5/18/2023. Therefore, the deficiency 87211(a)(1) has been corrected as of 5/18/23. An immediate civil penalty of $100 per day for a total of 13 days amounting to $1,300 is being assessed on an LIC421FC for failure to correct by POC due date of 5/5/2023.

An exit interview was conducted with Executive Directo Stefanie Ancheta and a copy of this report, the Licensee Rights (LIC9058 01/16) and LIC421FC were provided via hardcopy.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A RuizTELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023
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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