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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603817
Report Date: 05/24/2024
Date Signed: 05/24/2024 04:02:58 PM

Document Has Been Signed on 05/24/2024 04:02 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 34FACILITY NUMBER:
374603817
ADMINISTRATOR/
DIRECTOR:
RIVERA, VON ALLANNEFACILITY TYPE:
740
ADDRESS:14534 GARDEN RDTELEPHONE:
(858) 883-2707
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 6CENSUS: 0DATE:
05/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Administrator Von Rivera and House Manager Justin MendozaTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Juliana Barfield conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with House Manager Justin Mendoza.

According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom 6 may be non-ambulatory. During today’s inspection, there were no clients in care. This facility does not feature a secured perimeter or delayed egress doors.

LPA, accompanied by Administrator Von Rivera, toured the interior and exterior of the facility, and inspected each room. The facility is under interior renovation No pools or bodies of water were observed on the premises. Per the Administrator Von Rivera , no firearms or ammunition are kept at the facility. All smoke alarms are working. All sharp objects, toxic chemicals/poisons were locked in one room. There are no fireplaces, or open-faced heaters observed.

No deficiencies were observed or cited during today's annual inspection.



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

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SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Juliana Barfield
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2024
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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