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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604347
Report Date: 04/14/2021
Date Signed: 04/14/2021 01:41:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SUNSET COAST ASSISTED LIVINGFACILITY NUMBER:
374604347
ADMINISTRATOR:TAPIA, PATRICIAFACILITY TYPE:
740
ADDRESS:808 THERMAL AVETELEPHONE:
(619) 882-5003
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY:4CENSUS: 0DATE:
04/14/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Licensee, Vanessa NunezTIME COMPLETED:
01:00 PM
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Licensing Program Analysts (LPAs), Natasha Persaud and Marisela Garcia- Ceteno contacted the facility via video conference, due to COVID-19 to conduct a Case Management visit regarding an increase in capacity application. LPAs identified themselves and discussed the purpose of the call with Licensees, Vanessa Nunez and Patricia Tapia.

Licensees applied for an increase in capacity from four (4) ambulatory residents to six (6) ambulatory residents. There is an approved Fire Clearance dated 03/23/21 for the increase. As of today, there are no residents in care. LPA toured the facility and a had a discussion with the licensees regarding operation. It was discovered the licensee would prefer to change their ambulatory status. Licensees agreed to submit a new LIC 200 Application to reflect change in ambulatory status, and an LIC 999 Facility Sketch to reflect how many residents per bedroom.

Licensees were made aware, once they submit their request for the change, another fire inspection will be conducted. Upon Fire Department approval of the new fire clearance, another visit will be conducted by Community Care Licensing regarding the change is ambulatory status and capacity. No deficiencies were issued.

An exit interview was conducted with Licensee, Vanessa Nunez, via virtual visit, and a copy of this report, along with Licensee/Appeal Rights (LIC 9058 01/16), were provided to the Licensee via electronic mail. An electronic read receipt confirmation was requested to be sent by the Licensee upon receipt of the documents.
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2021
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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