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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880566
Report Date: 06/10/2022
Date Signed: 06/10/2022 02:06:26 PM


Document Has Been Signed on 06/10/2022 02:06 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
CCLD Regional Office, 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: 0DATE:
06/10/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
11:47 AM
MET WITH:Administrator- Montano RecintoTIME COMPLETED:
02:05 PM
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Licensing Program Analyst (LPA) Janira Arreola and Licensing Program Manager (LPM) Joel Esquivel had an informal office meeting with Administrator Recinto Montano.

The following issues were discussed:
  • Complaints SUBSTANTIATED- Medication being administered without a prescription.
  • Dead bolt used by Administrator in residents' rooms
  • Case Management and SUBSTANTIATED Complaint- Staff using common area in facility such as pantry and closet as sleeping quarters
  • Reporting requirements
  • Technical Support Program (TSP) was offered and accepted by administrator at the time of the meeting .

Administrator Montano Recinto agreed to correct the above issues and provide proof of compliance by June 15, 2022.

A copy of this report was reviewed with the facility administrator, Montano Recinto and a copy was provided.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira ArreolaTELEPHONE: 951-248-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 06/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2022
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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