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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604100
Report Date: 11/25/2024
Date Signed: 11/25/2024 03:14:54 PM

Document Has Been Signed on 11/25/2024 03:14 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:CASA DEL SOL RTF IIFACILITY NUMBER:
374604100
ADMINISTRATOR/
DIRECTOR:
VASQUEZ, MANUELFACILITY TYPE:
735
ADDRESS:1141 JULIETTE PLTELEPHONE:
(760) 645-3195
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: 4CENSUS: 0DATE:
11/25/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Licensee, Manuel VasquezTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced case management health and safety visit. LPA met with Licensee, Manuel Vasquez, who was informed of the purpose of the visit. At the time of the visit there are (1) staff and (2) clients who reside at Casa Del Sol RTF 374603419.LPA conducted a tour of the interior and exterior of the home.

The physical plant, furniture, and fixtures were present. The utilities are on and operating at the time of the visit. LPA observed the outdoor area and exits to be free of hazards. LPA observed the kitchen can prepare food in a clean and safe environment and the food supply was randomly audited. Food was found to be in required numbers and within date. The Guardian roster was reviewed with the licensee.

No immediate health or safety concerned were observed during the time of the visit. No deficiencies were cited at the time of the visit. An exit interview was conducted where this report was reviewed and provided.

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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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