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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604094
Report Date: 01/10/2025
Date Signed: 01/10/2025 11:10:16 AM

Document Has Been Signed on 01/10/2025 11:10 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:LIFE SAVER PLACE OF OCEANSIDEFACILITY NUMBER:
374604094
ADMINISTRATOR/
DIRECTOR:		BALANQUIT, IEZL LFACILITY TYPE:
740
ADDRESS:214 MANZANITA DRTELEPHONE:
(858) 284-9114
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
01/10/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Caregiver Rodolfo "Rudy" OnzaTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced case management visit to perform a health and safety check. LPA was greeted by, identified herself to, and explained the purpose of the visit with Caregiver Rodolfo "Rudy" Onza. LPA spoke with Licensee Zaldy Balanquit during the visit.

On 10/31/2024, Licensee Balanquit notified the Department that the facility's residents would need to temporarily relocated due to a water leak that caused damage to the facility. LPA and Licensee coordinated alternative placement for the residents into another licensed facility. During today's visit, Licensee informed LPA that residents had been relocated back to the facility on 1/9/2025.

During today’s visit, LPA conducted a health and safety check, toured the facility, inspected each room of the facility, and observed residents in care. The facility was kept at a comfortable temperature, the hot water was maintained within regulations, all hazardous and/or toxic chemicals were made inaccessible to residents, and resident's medications were centrally stored in a locked location. No health and/or safety concerns were observed during today's visit.

No deficiencies were cited on today’s date. An exit interview was conducted with Caregiver Rodolfo "Rudy" Onza, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).
Jennifer LottTELEPHONE: (619) 346-3976
Rebecca A BorundaTELEPHONE: (619) 318-7620
DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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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