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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604588
Report Date: 12/12/2024
Date Signed: 12/13/2024 04:47:44 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/13/2024 04:47 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:COASTAL PARADISE HOMESFACILITY NUMBER:
374604588
ADMINISTRATOR/
DIRECTOR:
NGUYEN, EDDIEFACILITY TYPE:
735
ADDRESS:6445 TOOLEY STTELEPHONE:
(619) 788-3343
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY: 4CENSUS: 4DATE:
12/12/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:30 AM
MET WITH:Licensee Eddie NguyenTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Required Annual Inspection. LPA was met at and granted entry into the facility by Eddie Nguyen, Licensee, to whom LPA disclosed the purpose of the visit.

According to the facility’s license, the facility is licensed for a maximum capacity of four (4) clients, all of whom must be ambulatory. During today’s inspection, there were four(4) clients in care.



LPA, accompanied by the licensee, toured the interior and exterior of the facility, and inspected each room. The facility was clean and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors and equipment inspected were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Hot water temperature at sink accessible to clients measured at 120 degrees Fahrenheit.


Refrigerator and freezer were operational and had sufficient space to store perishable items. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible.

No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept or will be stored in the facility. Smoke alarms were in working order. Fire extinguisher was present. First aid kit was complete and readily accessible. Required licensing postings were available for posting in a visible area of the facility.

No deficiencies were cited during today's annual inspection.

An exit interview was conducted with Eddie Nguyen, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the end of the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2024
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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