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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880653
Report Date: 08/16/2021
Date Signed: 08/16/2021 01:53:37 PM

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:ABSOLUTE DESERT CARE IIFACILITY NUMBER:
331880653
ADMINISTRATOR:CARLOS, CHANNEFACILITY TYPE:
740
ADDRESS:70603 INDEPENDENT CIRTELEPHONE:
(951) 742-3448
CITY:RNACHO MIRAGESTATE: CAZIP CODE:
92270
CAPACITY:6CENSUS: 3DATE:
08/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:26 AM
MET WITH:Nenita "Joney" CarlosTIME COMPLETED:
02:06 PM
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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced case management visit to the facility for a Health & Safety Check. LPA met with house manager Joney Carlos.

LPA toured the facility inside and out. There are charged fire extinguishers, operating smoke alarms, and carbon monoxide detectors. LPA observed that cleaning supplies, medications, and sharps were kept locked and inaccessible to the residents. Outdoor and indoor passageways were kept free of obstruction. LPA observed a sufficient amount of food supplies.

During this visit, LPA did not observe imminent health & safety concerns.

No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed and provided to the Mrs. Carlos..
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 248-0339
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021
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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