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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604726
Report Date: 03/20/2025
Date Signed: 03/20/2025 11:56:56 AM

Document Has Been Signed on 03/20/2025 11:56 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:SUNSET COAST ASSISTED LIVING 3FACILITY NUMBER:
374604726
ADMINISTRATOR/
DIRECTOR:		TAPIA, CHRISTINEFACILITY TYPE:
740
ADDRESS:4886 DOLIVA DRTELEPHONE:
(619) 481-4862
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY: 6CENSUS: 5DATE:
03/20/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:25 AM
MET WITH:Caregiver Priscilla RiveroTIME VISIT/
INSPECTION COMPLETED:
12:00 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) Sabel Martinez conducted an unannounced Plan of Correction (POC) visit. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Priscilla Rivero.

During today’s visit, the LPA reviewed documents and cleared the POCs that were due. The LPA printed POC letter and provide it to the staff.

An exit interview was conducted with Caregiver Priscilla Rivero, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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 1