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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604347
Report Date: 05/18/2023
Date Signed: 05/18/2023 06:03:39 PM

Document Has Been Signed on 05/18/2023 06:03 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SUNSET COAST ASSISTED LIVINGFACILITY NUMBER:
374604347
ADMINISTRATOR:TAPIA, PATRICIAFACILITY TYPE:
740
ADDRESS:808 THERMAL AVETELEPHONE:
(619) 882-5003
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY: 6CENSUS: 4DATE:
05/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Administrator, Patricia TapiaTIME COMPLETED:
05:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced case management visit at the facility. LPA was greeted at the front entrance by Caregiver, Katia Perez and granted entry after identifying herself. LPA explained the purpose of the visit to Licensee, Patricia Tapia.

The purpose of this visit was to discuss the facility’s current 30 Day Eviction Notice. During today’s visit, LPA Garcia-Centeno went over the 30 day eviction notice with Licensee, Tapia.

An exit interview was conducted with Licensee, Tapia a copy of this report, and Licensee/Appeals Rights (LIC 9058 01/16) was provided to Licensee.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2023
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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