<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604255
Report Date: 10/20/2023
Date Signed: 10/20/2023 04:16:54 PM

Document Has Been Signed on 10/20/2023 04:16 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:SILVERADO SENIOR LIVING-ESCONDIDOFACILITY NUMBER:
374604255
ADMINISTRATOR:KELLIE SMITHFACILITY TYPE:
740
ADDRESS:1500 BORDEN ROADTELEPHONE:
(760) 737-7900
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 104CENSUS: 62DATE:
10/20/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Executive Director, Kellie Pacheco-SmithTIME COMPLETED:
10:40 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced Collateral visit. LPA met with Executive Director, Kellie Pacheco-Smith and discussed the purpose of the visit was to interview a resident.

An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Executive Director, Kellie Pacheco-Smith whose signature below confirms receipt of these rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1