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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880556
Report Date: 02/18/2026
Date Signed: 02/18/2026 04:21:37 PM

Document Has Been Signed on 02/18/2026 04:21 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:E.X.C.E.L HOUSE, THEFACILITY NUMBER:
331880556
ADMINISTRATOR/
DIRECTOR:		STOKES, LATASHAFACILITY TYPE:
735
ADDRESS:24051 MARIE STREETTELEPHONE:
(951) 722-4438
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY: 4CENSUS: 4DATE:
02/18/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Latasha Stokes-Walls, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 2/18/2026, Licensing Program Analyst’s (LPA’s) Ahliah Sharp and Valerie Flores conducted an unannounced one-year required visit. LPA’s met with staff Dr. Akwesi Assensoah-Kodua and explained the purpose of the visit. LPA’s were granted entry into the facility and observed the following during the visit:

The facility is a single-story structure which consists of (4) four client bedrooms, (2) two bathrooms, (2) two living rooms, dining room, kitchen and garage. During the tour, LPA’s observed a storage room located in the garage. Upon observation, it appeared to be utilized as a living quarter. Per Administrator, the storage space was intended for staff use when taking a break in-between shifts. Administrator was advised to remove the bedding from the storage as it is prohibited by California Code of Regulation Title 22. LPA’s observed indoor and outdoor passageways to be free from obstruction. Client bedrooms were equipped with the required bedding, furniture, and functional lighting. Non-private bathrooms were observed to have night-lights that led to the bathroom. The kitchen area was observed to be organized and sanitary. The facility maintained the required (2) two-day supply of perishable foods and (7) seven-day supply of non-perishable foods. LPA observed emergency food and water to be stored in the garage. Knives and other sharp items were stored in a lockbox. The facility operates laundry services on-site. The washer and dryer were observed to be in good repair. Dual carbon monoxide/smoke detectors were observed to be fully operable. LPA’s observed an outdoor area with sufficient shading and seating. An activity calendar was observed to be posted on the wall in the living room. Medication was observed to be centrally stored in a locked filing cabinet. Cleaning supplies and other disinfectants were observed in a closet equipped with a lock. The facility maintained an adequate supply of linen and towels for client use. LPA’s did not observe any pools or bodies of water. Per Dr. Akwesi, there are no firearms and/or ammunition on the premises.

(Continue to LIC809C)

NAME OF LICENSING PROGRAM MANAGER: Jazmond D Harris
NAME OF LICENSING PROGRAM ANALYST: Ahliah Sharp
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: E.X.C.E.L HOUSE, THE
FACILITY NUMBER: 331880556
VISIT DATE: 02/18/2026
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(Continuation from LIC809)

See Something Say Something, Client/Employee Personal Rights, Emergency Disaster, Facility Sketch, and License were posted on the wall near the entryway. Client records reviewed included but not limited to signed admission agreements, preplacement appraisals, current IPP, safeguard cash resources, medical assessments, weight charts, and personal rights. Staff records reviewed included but were not limited to valid first-aid/CPR Certification, fingerprint clearance, criminal record statement, health screening, TB results, and relevant trainings.

LPA’s did not observe any immediate health and safety concerns.

An exit interview was conducted, and a copy of this report was provided to Administrator Latasha Stokes-Walls.

LPAs were off sight from 12:33pm and returned at 1:03pm

NAME OF LICENSING PROGRAM MANAGER: Jazmond D Harris
NAME OF LICENSING PROGRAM ANALYST: Ahliah Sharp
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC809 (FAS) - (06/04)
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