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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006485
Report Date: 12/23/2024
Date Signed: 12/23/2024 03:15:20 PM

Document Has Been Signed on 12/23/2024 03:15 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
ORANGE COUNTY ASC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:HILLS OF VIA DEL SOL, THEFACILITY NUMBER:
306006485
ADMINISTRATOR/
DIRECTOR:		CUYSON, ELEAZARFACILITY TYPE:
740
ADDRESS:26462 VIA DEL SOLTELEPHONE:
(714) 430-7672
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 6CENSUS: 5DATE:
12/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH:Eleazar CuysonTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 12/23/2024, LPA Mason arrived at the facility for the purpose of conducting a case management visit. LPA was greeted and granted entry by facility staff. LPA met with Eleazar Cuyson, Administrator and explained the purpose of the visit.

On 12/13/2024 the Department received notification that the facility is delinquent in their lease payments. The facility stated they attempted payment on the first of the month but the transaction was unable to be processed. On 12/17/2024, the Department contacted the facility requesting proof of payment. The facility stated they received the communication, but have not provided proof to the Department yet.The facility stated they made the payment on 12/21/2024. LPA advised the facility that they would be issuing a Technical Violation and urged the facility to provide the Department with proof of the lease payment as soon as possible.

Based on today's Case Management visit, a technical violation is being issued. The LPA reviewed the report with the facility and provided a copy of the LIC809 and LIC9102 to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE: DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/23/2024
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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