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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603813
Report Date: 02/07/2025
Date Signed: 02/07/2025 03:43:15 PM

Document Has Been Signed on 02/07/2025 03:43 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SOLARIS 28FACILITY NUMBER:
374603813
ADMINISTRATOR/
DIRECTOR:		RIVERA, VONFACILITY TYPE:
740
ADDRESS:14528 GARDEN RDTELEPHONE:
(858) 883-5945
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 6CENSUS: 4DATE:
02/07/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:01 AM
MET WITH:Jushua "Justin" Mendoza, AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Case Management visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Justin Mendoza, Administrator.

LPA briefly toured the facility, performed a health and safety welfare check. There are four residents at this facility at this time. LPA Rodgers spoke with staff and residence.

No deficiencies were observed or cited on this date. No heath and safety concerns at this time.

An exit interview was conducted with Justin Mendoza, Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2025
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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