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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880653
Report Date: 05/24/2023
Date Signed: 05/24/2023 12:21:08 PM


Document Has Been Signed on 05/24/2023 12:21 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
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: 0DATE:
05/24/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Rachel Nicole Carlos, relative of AdministratorTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) Yolanda Delgado conducted an unannounced visit for the purpose of the facility's closure. Administrator Channe Carlos emailed LPA Stephanie Torres on April 7, 2023 to forfeit their license for the closure. LPA Delgado was met by Administrator's relative, Rachel Nicole Carlos.

On 4/17/2023, LPA Torres contacted the Administrator regarding closing the facility. LPA was informed that there was no date as of yet the facility was going to close. The licensee is initiating this closure. The effective date of closure was 4/30/2023.

LPA inspected the facility which included the bedrooms, bathrooms, dining area, kitchen and outdoor areas. LPA confirmed there are no clients present, and there were no belongings of clients in the facility. There is on-construction during the visit.

Rachel Carlos submitted the following during the closure plan:
1. Original license to CCLD.

An exit interview was conducted where this report was discussed with Rachel Carlos and will be emailed to the email address on file.
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Yolanda DelgadoTELEPHONE: (951) 203-2990
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2023
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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