Senior Care Records.

Facility Evaluation Report

Pacific Solstice LLC, San Clemente06/12/2024Licence 306006325

Capacity6
Census3
Date signed06/12/2024 03:48:40 PM
The inspector’s account

Licensing Program Analyst (LPA) Jessica Cho continued the visit after initiating a complaint investigation in connection to Complaint Control Number: 22-AS-20240606121507. LPA stated the purpose of the visit to Administrator Britten Devereux. LPA observed Staff #1 (S1) was not fingerprint cleared and Staff #2 (S2) was not associated per the Licensing Information System (LIS) dated June 11, 2024 and the Guardian Employee Roster dated June 12, 2024 as required per the Criminal Record Clearance of the Title 22 Regulations. S1 stated that they were employed on April 17, 2024 and S2 on April 11, 2024. S2 was associated S1 completed their live scan during the visit.

A deficiency is being cited as per the Title 22, Division 6, Chapter 2 of the California Code of Regulations. See the attached LIC809-D. An immediate civil penalty is being assessed. See the attached LIC421BG.

An exit interview was conducted with Administrator Britten Devereux, and a copy of this report including the LIC421BG, LIC811, and the appeal rights were provided at the end of the visit.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction