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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331800064
Report Date: 08/26/2021
Date Signed: 08/26/2021 12:24:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:SACRED HEART-STOYVIEWFACILITY NUMBER:
331800064
ADMINISTRATOR:MACIAS, EVELYNFACILITY TYPE:
740
ADDRESS:37189 STOYVIEW CIRCLETELEPHONE:
(951) 698-4258
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: DATE:
08/26/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:18 PM
MET WITH:TIME COMPLETED:
12:30 PM
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At approximately 12:20 PM, Licensing Program Analyst (LPA) Jesse Gardner arrived unannounced to conduct an annual inspection with an emphasis on infection control.

LPA Gardner rang the facility doorbell several times but did not receive an answer. LPA Gardner could hear the doorbell ringing from inside the facility. Several miscellaneous solicitation notices were left in the door jam. LPA Gardner called the licensee and left a message. This annual inspection would be rescheduled.
SUPERVISOR'S NAME: Reyna LaceyTELEPHONE: (951) 248-0341
LICENSING EVALUATOR NAME: Jesse GardnerTELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
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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