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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374601005
Report Date: 01/17/2025
Date Signed: 01/17/2025 11:18:46 AM

Document Has Been Signed on 01/17/2025 11:18 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:VETERANS HOME CHULA VISTAFACILITY NUMBER:
374601005
ADMINISTRATOR/
DIRECTOR:		KATHRYN GABRIELFACILITY TYPE:
740
ADDRESS:700 EAST NAPLES COURTTELEPHONE:
(619) 205-1154
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 55CENSUS: 19DATE:
01/17/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH:Administrator Kathryn GabrielTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced health and safety visit to Veterans Home Chula Vista for thirteen (13) residents temporary relocated from Veterans Home of California West LA, address: 11500 Nimitz Avenue, Los Angeles, CA, 90049. The residents' home facility in Los Angeles was temporarily closed due to the widespread wild fires disaster in the area.

LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to facility Administrator Kathryn Gabriel. LPA was informed by Administrator Gabriel that 12 of the temporary residents had just left earlier this morning back to their home facility at 9:00 am. One (1) had stayed with nearby family and drove themselves back to their home facility. The residents stayed at Veterans Home Chula Vista from 1/11/25-1/17/25. No records were collected during the visit. LPA did not observe any health or safety concerns.

No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Gabriel, to whom a copy of this report was provided. Their signature below confirms receipt of this document.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2025
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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