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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880566
Report Date: 08/21/2024
Date Signed: 08/21/2024 12:49:16 PM


Document Has Been Signed on 08/21/2024 12:49 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:FIRST CHOICE SENIOR LIVINGFACILITY NUMBER:
331880566
ADMINISTRATOR:RECINTO, MONTANO OFACILITY TYPE:
740
ADDRESS:34796 MYOPORUM LNTELEPHONE:
(951) 599-4305
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 5DATE:
08/21/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Montano Recinto - AdministratorTIME COMPLETED:
12:55 PM
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Licensing Program Analyst (LPA) Sara Martinez arrived unannounced to the facility to conduct a collateral visit to deliver complaint determination findings for one (1) complaint investigation unrelated to this facility. LPA met with Administrator Montano Recinto and explained the purpose of the visit.

There were no health and safety concerns observed during the time of this visit. An exit interview was conducted where a copy of this report was provided to Administrator Recinto.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:
DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/21/2024
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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