<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880653
Report Date: 01/08/2024
Date Signed: 01/08/2024 02:45:41 PM


Document Has Been Signed on 01/08/2024 02:45 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: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:0CENSUS: 0DATE:
01/08/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Nenita Carlos, Staff/RepresentativeTIME COMPLETED:
02:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA), Stephanie Martinez, conducted an announced office meeting with Staff/Representative, Nenita Carlos, on the above date for the purpose of amending a report relating to complaint #18-AS-20230323131654. The LPA informed Licensee, Channe Carlos, of the purpose for the meeting via telephone. Licensee Carlos approved the LPA to meet with representative, Nenita Carlos.

Due to the facility being closed, the LPA met with Licensee's representative, Nenita Carlos, to amend one out of three pages from the Complaint Investigation Report dated 10/30/2023.

This report was reviewed with Nenita Carlos, who signed the report, and a copy was provided.
SUPERVISOR'S NAME: Rikesha StampsTELEPHONE: (951) -212-0616
LICENSING EVALUATOR NAME: Stephanie MartinezTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:
DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1