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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331800208
Report Date: 12/16/2024
Date Signed: 12/16/2024 04:03:13 PM

Document Has Been Signed on 12/16/2024 04:03 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:ALPHA CHRISTIANS HOMES AT WOLLYLEAFFACILITY NUMBER:
331800208
ADMINISTRATOR/
DIRECTOR:		AURELIO BESINAFACILITY TYPE:
735
ADDRESS:3049 WOOLYLEAF CTTELEPHONE:
(951) 349-0321
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 5CENSUS: 4DATE:
12/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:43 PM
MET WITH:Marlita Jimena - AdmininstratorTIME VISIT/
INSPECTION COMPLETED:
04:14 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) Ferrer Sabarias conducted an unannounced annual visit. Upon arrival, LPA was granted entry and met with and the Administrator Marlita Jimena who was informed of the purpose of the visit. At the time of the inspection, there was three (3) staff members and zero (0) client present.

The facility is a two-story home with six bedrooms and four bathrooms, complete with an attached garage. No pools or other bodies of water was observed on the property, according to Administrator no firearms or dangerous weapons are stored at the facility.



During the inspection, LPA observed the hand washing stations in the facility restrooms and kitchen, which were equipped with hand hygiene supplies and hand washing signs. Additionally, LPA observed the presence of personal protective equipment (PPE) and cleaning supplies for regular facility maintenance. LPA reviewed the facility’s infection r plan, which met department requirements. LPA reviewed staff records and found that all staff had infection control training.

LPA inspected the client and staff bedrooms. The physical plant, including floors, windows, and doors, were found to be clean. Fixtures and furniture were well maintained. The outdoor area was hazard-free, with outdoor furniture and a shaded space for clients. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to clients. Smoke and carbon monoxide detectors were observed to be operational, and the hot water temperature was set to 112.8 °F. Two fire extinguisher are current with an inspection of 10/10/2024.

Continue on LIC809C...

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Ferrer Sabarias
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ALPHA CHRISTIANS HOMES AT WOLLYLEAF
FACILITY NUMBER: 331800208
VISIT DATE: 12/16/2024
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
26
27
28
29
30
31
32
Continued from LIC809…

LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required two (2) day supply of perishable and seven (7) day supply of non-perishable foods.

LPA also reviewed the staff schedules showing adequate staff coverage. Facility sketch, exit routes, personal rights, complaint information and emergency phone numbers were found posted in the facility. The listed administrator possesses a current certificate valid until 11/04/25.

All client’s medication are locked in a cabinet located in the kitchen area. LPA reviewed medications for four (4) clients and found all medication listed on MAR and all required labeling was found to be in place.



LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing the facility performs monthly fire and earthquake drills, which met the department requirements. LPA observed all facility exits were clear from obstructions. LPA observed first aid kit with all required items.

An exit interview was conducted where a copy of this report was provided to Administrator Jimena.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Ferrer Sabarias
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2