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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603814
Report Date: 02/26/2025
Date Signed: 02/26/2025 11:41:38 AM

Document Has Been Signed on 02/26/2025 11:41 AM - 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 30FACILITY NUMBER:
374603814
ADMINISTRATOR/
DIRECTOR:		ARCA, LUCIAFACILITY TYPE:
740
ADDRESS:14530 GARDEN RDTELEPHONE:
(858) 883-2680
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 6CENSUS: DATE:
02/26/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
NARRATIVE
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Case Management visit to respond to observations and interviews from a visit conducted on 2/8/2025. LPA was greeted by, identified herself to, and explained the purpose of the visit with Administrator Jushua "Justin" Mendoza.

On 2/08/2025 LPA Observed cobwebs in all bathrooms and all bedrooms.  All resident doors had  fingerprints and splotches of dirt.  All Bathroom shelves have brown splotches and brown spots. The kitchen cabinets had outside debris/dirt and grease. The oven vent was greasy and had debris/dirt. The back yard shed was in disrepair and had a door hanging to the side. The  back yard fence in disrepair: missing pieces of fence and lattice is hanging off top of fence.

Based on the inspection, deficiencies were observed in the areas evaluated, and observed deficiencies is listed on the LIC 809-D page.  An exit interview was conducted, and this report was discussed with Administrator Mendoza.  A copy of this report and Licensee/Appeal Rights (01/2016) were provided to the Administrator at the conclusion of the visit, and his signature on this form acknowledges receipt of the rights and a copy of this report.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 02/26/2025 11:41 AM - It Cannot Be Edited


Created By: Amy Rodgers On 02/25/2025 at 08:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SOLARIS 30
FACILITY NUMBER: 374603814

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/12/2025
Section Cited
CCR
87303(a)

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(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance... for the safety and well-being of residents, employees and visitors.

This requirement is not met as evidenced
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LPA spoke as well as toured the property with Administrator on 2/7/2025. Administrator was instructed by LPA to clean and repair the inside of the facility as well as the repair of backyard fencing and outside storage shed.
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Based on observations, the licensee did not ensure the facility was in good repair for 5 out of 5 [R1-R5] residents, due to , cobwebs in bathrooms and bedrooms, outside debris/dirt and greasy cabinets, greasy debris/dirt stove vent, back yard shed in disrepair, back yard fence in disrepair which poses a potential health and safety risk to persons in care.

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LPA observed a clean and in good repair facility on 3/12/2025.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Denise Powell
LICENSING EVALUATOR NAME:Amy Rodgers
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2025


LIC809 (FAS) - (06/04)
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