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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604120
Report Date: 09/26/2024
Date Signed: 09/30/2024 03:46:03 PM

Document Has Been Signed on 09/30/2024 03:46 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:HUMMINGBIRD HEALING HOUSEFACILITY NUMBER:
374604120
ADMINISTRATOR/
DIRECTOR:		TATUNAY, NICOLEFACILITY TYPE:
772
ADDRESS:5550 UNIVERSITY AVE STE BTELEPHONE:
(619) 481-6790
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 16CENSUS: 14DATE:
09/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:03 PM
MET WITH:Adriana Sanchez Vocational CoordinatorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced visit to deliver amended findings. LPA identified herself, was granted entry, and stated the purpose of the visit to Adriana Sanchez Vocational Coordinator. 

LPA Domingo reviewed the LIC802 and explained the additional allegation that was added and reviewed that findings. The allegation that was added along with Staff do not keep the facility free of odors was Facility staff smoking cannabis on facility grounds while on duty.

The LIC9099 was amended and the findings remain the same, unsubstantiated.


An exit interview was conducted with Adriana Sanchez Vocational Coordinator. A copy of this report and Licensee Appeal Rights (9058 03/22) were provided to Vocational Coordinator, Adriana Sanchez after the conclusion of the visit,
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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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