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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604860
Report Date: 03/11/2025
Date Signed: 03/11/2025 02:21:46 PM

Document Has Been Signed on 03/11/2025 02:21 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:DEL CERRO ELDER CAREFACILITY NUMBER:
374604860
ADMINISTRATOR/
DIRECTOR:		RATHI, GAURAVFACILITY TYPE:
740
ADDRESS:6288 WENRICH DRTELEPHONE:
(619) 791-5495
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY: 6CENSUS: 6DATE:
03/11/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Co- Administer Jenny SequeiraTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Arian Golbakhsh and Amy Rodgers conducted an unannounced Case Management visit. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Co-Administrator Jenny Sequeira.

LPA briefly toured the facility, performed a health and safety welfare check. There are six (6) residents at the facility at this time. LPAs Rodgers and Golbakhsh spoke with staff.

No deficiencies were observed or cited on this date.

An exit interview was conducted with Co-Administrator Sequeira 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: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
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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