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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603815
Report Date: 01/25/2024
Date Signed: 01/25/2024 12:58:10 PM

Document Has Been Signed on 01/25/2024 12:58 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
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SOLARIS 36FACILITY NUMBER:
374603815
ADMINISTRATOR:ARCA, LUCIAFACILITY TYPE:
740
ADDRESS:14536 GARDEN RDTELEPHONE:
(858) 842-4246
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 6CENSUS: 6DATE:
01/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Joseph Bisco, CaregiverTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Daniel Pena, conducted an unannounced Case Management-Other visit to the facility. LPA was greeted at the entrance by Caregiver, Joseph Bisco. After identifying himself and explaining the purpose of the visit, LPA was allowed inside.

During the visit, LPA toured the facility, interacted and observed six residents and two staff. LPA conducted a health and safety check of all residents present. No health and safety concerns nor deficiencies were observed and no citations were given.

An exit interview was conducted with Caregiver, Bisco and a copy of this report and the Licensee Appeal/Rights was given to Mr. Bisco. Mr. Bisco's signature serves as receipt for the documents provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2024
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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