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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604544
Report Date: 03/09/2023
Date Signed: 02/07/2024 05:08:26 PM


Document Has Been Signed on 02/07/2024 05:08 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:PACIFICA SENIOR LIVING BONITAFACILITY NUMBER:
374604544
ADMINISTRATOR:MARKOVICH, PAULFACILITY TYPE:
740
ADDRESS:3434 BONITA ROADTELEPHONE:
(619) 476-9444
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:145CENSUS: 97DATE:
03/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:40 PM
MET WITH:Busines Office Manager Rebecca TovesTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Liliana Silveira conducted a case management visit to give a technical advisory for an issue identified while conducting a complaint investigation visit. LPA Silveira gained access to the facility and met with Business Office Manager Rebecca Toves and explained the purpose of the Case Management.

LPA reviewed Title 22 regulations with Rebecca Toves regarding Admission Agreements and the required protocols that must be followed when processing a refund after a resident's death.

A technical advisory was given Per Title 22, Division 6, Chapter 8 of the California Code of Regulations (see LIC9102). An exit interview was conducted with Rebecca, to whom a copy of this report and the Licensee appeal Rights (LIC9058) were provided.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana SilveiraTELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023
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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