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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604539
Report Date: 11/20/2024
Date Signed: 11/20/2024 03:43:10 PM

Document Has Been Signed on 11/20/2024 03:43 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:PACIFICA SENIOR LIVING ENCINITASFACILITY NUMBER:
374604539
ADMINISTRATOR/
DIRECTOR:		WATKINS, MELISSAFACILITY TYPE:
740
ADDRESS:504 S EL CAMINO REALTELEPHONE:
(760) 452-0615
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 90CENSUS: 26DATE:
11/20/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Executive Director Melissa WatkinsTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced case management visit. LPA was welcomed by and discussed the purpose of the visit with Executive Director Melissa Watkins.

On 10/16/2024 the Licensee notified the Department of the intent to terminate the facility's license, effective 12/15/2024. LPA toured the facility and conducted a welfare/safety check on all residents currently residing in the facility. LPA Patterson confirmed with Executive Director Melissa Watkins that all residents have been notified with an eviction letter, dated 10/14/2024. Interviews with staff and clients verified that residents were informed of the future facility closure. LPA verified a relocation and tracking process was in place for residents.

No deficiencies were cited or observed during the facility visit.

An exit interview was conducted with Executive Director Melissa Watkins, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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