374604347-11-17-2025-08-AS-MGCO-DNJ95U-20251117220430

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374604347
Report Date: 11/17/2025
Date Signed: 11/17/2025 10:36:33 PM

Document Has Been Signed on 11/17/2025 10:36 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:	SUNSET COAST ASSISTED LIVING		FACILITY NUMBER:	374604347
ADMINISTRATOR/ DIRECTOR:	TAPIA, PATRICIA		FACILITY TYPE:	740
ADDRESS:	808 THERMAL AVE		TELEPHONE:	(619) 882-5003
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92154
CAPACITY: 6		CENSUS: 6	DATE:	11/17/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:	Administrator, Karina Lopez		TIME VISIT/ INSPECTION COMPLETED:	04:30 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) Marisela Garcia-Centeno conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. Upon arrival, LPA identified herself and was granted entry by Caregiver Lizbeth Caudillo. LPA met with Administrator Karina Lopez and explained the purpose of the visit. It was noted that Caregiver Caudillo had a current criminal record clearance; however, she was not associated with this facility. According to the facility license, the facility is approved for a maximum capacity of six (6) elderly residents ages 60 and above, all of whom may be non-ambulatory, and has a hospice waiver for up to four (4) residents. During today’s inspection, six (6) residents were in care, all non-ambulatory. The facility does not have a secured perimeter or delayed-egress doors. LPA Garcia-Centeno, accompanied by Caregiver Caudillo, toured the interior and exterior of the facility, including resident bedrooms. The facility was clean, well-maintained, and free of obstruction or slip hazards. Resident bedrooms contained required furnishings, and all doors, toilets, and showers were operational. Adequate linens and hygiene supplies were available. The facility provided sufficient space and equipment for dining, laundry, visitation, meetings, and activities. The facility’s internal temperature, refrigerator, and freezer were within regulatory ranges. Hot water temperature in the resident-accessible kitchen faucet measured 110 degrees, which is within regulatory limits. The facility maintained at least two (2) days of perishable food and seven (7) days of non-perishable food, all properly stored. Cooking and dining equipment were present. No sharp objects, toxic chemicals, fireplaces, or open-faced heaters were accessible to residents. (continue at LIC809C)

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: SUNSET COAST ASSISTED LIVING	FACILITY NUMBER: 374604347
	VISIT DATE: 11/17/2025

NARRATIVE

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(continue from LIC809)

Medications were properly labeled and stored in locked areas. Confidential resident and staff records were secured. No pools or bodies of water were observed. Per the Administrator, no firearms or ammunition are kept on the premises. Smoke alarms, carbon monoxide detectors, emergency lighting, and the facility telephone were operational. Fire extinguishers were serviced within the last 12 months on October 22, 2025. The first aid kit was complete and accessible. Required licensing postings were observed. Emergency drills were conducted in August 2025 and again this morning, November 17, 2025.

LPA interviewed staff and residents and reviewed staff and resident files. No licensing concerns were identified through interviews. Resident files contained required documentation. Staff files included proof of current first aid training. The Administrator provided proof of current business liability insurance.

Civil penalties in the amount of $900 were assessed for violations and are documented on the attached LIC 421. A plan of correction was developed in coordination with Administrator Karina Lopez.

An exit interview was conducted with Administrator Karina Lopez. She was provided copies of this report, LIC 809D Deficiencies, LIC 421 Civil Penalty, and Licensee/Appeal Rights (LIC 9058, 03/22).

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/17/2025 10:36 PM - It Cannot Be Edited

Created By: Marisela Garcia-Centeno On 11/17/2025 at 04:34 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SUNSET COAST ASSISTED LIVING	FACILITY NUMBER: 374604347
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/17/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

87355(e)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 5 staff were not associated to the facility roster, which poses an immediate safety risk to 6 out of 6 persons in care.
	POC Due Date: 12/17/2025
	Plan of Correction
1 2 3 4	Administrator completed the association for one of the staff members during the visit on 11/17/2025 which eliminated immediate safety risk to residents in care. Adminstrator agreed to associated the 2nd caregiver prior to returning to work. Administrator agreed to submit documentaion of the association for the 2nd staff member and conduct staff training on personnel requirements to ensure staff are associated prior to working by POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Sabel Martinez
NAME OF LICENSING PROGRAM MANAGER:

	Marisela Garcia-Centeno
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/17/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2025

LIC809 (FAS) - (06/04)

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