<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604751
Report Date: 03/18/2025
Date Signed: 03/18/2025 03:40:41 PM

Document Has Been Signed on 03/18/2025 03:40 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:NANCY VASQUEZ RESIDENTIAL CARE CENTERFACILITY NUMBER:
374604751
ADMINISTRATOR/
DIRECTOR:		CURTIS, PHILIP C.FACILITY TYPE:
735
ADDRESS:8627 TROY STREETTELEPHONE:
(619) 754-5250
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 40CENSUS: 37DATE:
03/18/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:01 PM
MET WITH:Nick Fierro, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:05 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
Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced Case Management - Incident visit. LPA was welcomed by and identified herself to Nick Fierro, Administrator and discussed the purpose of the visit.

Today's visit was in response to an LIC 624 Incident Report, which licensee self submitted to the CCLD San Diego Regional Office (received on 03/17/2025). According to the LIC 624: on 03/06/2025, Client #1 (C1) went AWOL (absent without leave) from the facility. [See LIC 811 Confidential Names List for a description of C1.] On 03/06/2025, C1 left for a walk and did not return to the facility. On 03/06/2025 C1 was picked up by the El Cajon police and brought to the hospital at 3pm. Interview with the Administrator revealed that if C1 was not picked up by police they most likely would have arrived back to the facility. Interviews revealed C1 was medication compliant and there were no surrounding issues. Interviews revealed they feel as though C1 just left to take a walk. Interviews revealed staff made several checks around the facility then they contacted the sheriffs department to report the AWOL.

According to C1’s latest LIC 602 Physician’s Report (dated 05/04/2024): C1’s primary diagnoses were are Schizophrenia with acute exacerbation. According to C1 physicians report C1 is able to safely leave the facility unassisted.


According to the facility’s Absentee Notification Plan/Policy: When a client such as C1 is AWOL from the facility, staff are to search the facility for the client and then notify the administrator if the client has not been accounted for by the end of the shift. Within a 24 hour period, these measures will be taken, contact clients authorized representative, LPA and it is noted that staff are to notify law enforcement after 72 hours for a missing persons report.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: NANCY VASQUEZ RESIDENTIAL CARE CENTER
FACILITY NUMBER: 374604751
VISIT DATE: 03/18/2025
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
26
27
28
29
30
31
32
Records and interviews revealed: C1 has lived at the facility for around eight (8) months, Facility staff called law enforcement and before a deputy could make it to the facility to take the report, the hospital contacted the facility regarding C1s wherabouts.

CCLD concluded: Facility staff provided needed supervision to C1 leading up to the AWOL. Licensee had a written Absentee Notification Plan as part of C1’s record of care, and staff followed this plan.

No deficiencies were cited for the above incident. No deficiencies were observed or cited during today's visit.

An exit interview was conducted with Nick Fierro, to whom a copy of this report, the LIC 811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
LIC809 (FAS) - (06/04)
Page: 2 of 2