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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604715
Report Date: 11/20/2024
Date Signed: 11/20/2024 04:46:55 PM

Document Has Been Signed on 11/20/2024 04:46 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:WAREENA OPTIONSFACILITY NUMBER:
374604715
ADMINISTRATOR/
DIRECTOR:		SLAIWA, MATTHEWFACILITY TYPE:
735
ADDRESS:2203 CASA ALTATELEPHONE:
(619) 312-7999
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 6CENSUS: 0DATE:
11/20/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:01 PM
MET WITH:Matthew Slaiwa, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) Tiffany Holmes conducted a case management visit regarding licensee initiated facility closure. LPA was greeted by, identified herself to, and discussed the purpose of the visit with the licensee's representative, Administrator Matthew Slaiwa.

During today's visit, LPA briefly toured the facility and verified that there were no clients in care. According to the Administrator they were never vendorized by the San Diego Regional Center (SDRC). Facility is ready for closure

No deficiencies were issued, and the facility is ready for closure.

An exit interview was conducted with Administrator Matthew Slaiwa, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
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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