<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
374604580
Report Date:
11/17/2023
Date Signed:
11/18/2023 07:52:05 AM
Document Has Been Signed on
11/18/2023 07:52 AM
- 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:
NATURE'S RESIDENCE
FACILITY NUMBER:
374604580
ADMINISTRATOR:
ANDRADE, VICTOR JOSE R
FACILITY TYPE:
735
ADDRESS:
8554 S SLOPE DRIVE
TELEPHONE:
(619) 499-5150
CITY:
SANTEE
STATE:
CA
ZIP CODE:
92071
CAPACITY:
3
CENSUS:
DATE:
11/17/2023
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
04:15 PM
MET WITH:
TIME COMPLETED:
04:30 PM
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
SUPERVISORS NAME
:
Simon Jacob
LICENSING EVALUATOR NAME
:
Debbie Correia
LICENSING EVALUATOR SIGNATURE
:
DATE:
11/16/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2023
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