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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331800078
Report Date: 09/18/2024
Date Signed: 09/18/2024 02:34:46 PM


Document Has Been Signed on 09/18/2024 02:34 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:BLESSED CAREFACILITY NUMBER:
331800078
ADMINISTRATOR:GURAU, JOHNFACILITY TYPE:
740
ADDRESS:6810 CORONADO WAYTELEPHONE:
(951) 786-0106
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:6CENSUS: 0DATE:
09/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Administrator John GurauTIME COMPLETED:
02:45 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) Sara Martinez arrived unannounced to conduct the required annual inspection. LPA was granted entry and met with and stated the facility Administrator John Gurau who was informed of the purpose for the visit. Gurau reported the facility currently does not have residents in care at the home. The facility has not had residents admitted since 2017. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted interviews. LPA observed the following:

Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were in good repair and were present. The facility does not contain any bodies of water, guns, and ammunition on the property. The outdoor area was observed to be free of hazards. The facility has the capability to have the sharp and dangerous objects locked and inaccessible to the residents in care. The smoke detector and carbon monoxide was operational, and the hot water temperature met department requirements. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. Facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. The facility has the capabilities to lock and store cleaning supplies, soap, and detergents so they are inaccessible to residents in care. Centrally stored medication will be locked in a cabinet located in the hallway when residents are admitted. LPA observed all facility exits were clear from obstructions. LPA observed emergency supplies and first aid kit with all required items. Two (2) fireplaces located throughout the facility was equipped with an appropriate covering. Facility contains a charged fire extinguisher.

No deficiencies were cited at the time of the visit.

An exit interview was conducted where a copy of this report was provided to Administrator Gurau.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:
DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2024
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