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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880733
Report Date: 10/12/2022
Date Signed: 10/12/2022 09:16:59 AM


Document Has Been Signed on 10/12/2022 09:16 AM - 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 LIVING 2FACILITY NUMBER:
331880733
ADMINISTRATOR:RECINTO, MONTANO OFACILITY TYPE:
740
ADDRESS:40147 GRENACHE CTTELEPHONE:
(951) 239-0132
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 0DATE:
10/12/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee Montano RecintoTIME COMPLETED:
09:20 AM
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Licensing Program Analyst (LPA) Janira Arreola arrived at the facility on 10/12/2022 at 9:00 am to confirm that all of the residents have been relocated in anticipation for the facility's closure. LPA met with Licensee Monatano Recinto who had informed LPA through e-mail that the property owner was planning on selling the home and that the facility would be closing. LPA received notification that all (3) resident had been relocated on 9/30/2022 via e-mail and had received a scanned copy of the facility's license from Recinto.

LPA observed the facility was vacant, there were some facility belongings such as extra linens and extra commodes in the facility garage. All rooms, living rooms, dining rooms, backyard and bathrooms were void of residents and furniture.

Due to observations made, LPA concluded that all residents have been successfully relocated and the facility is no longer providing care and supervision to any residents. Licensee Montano is voluntarily relinquishing their license to this facility, which is no longer in operation as confirmed by LPA on this date, 10/12/2022. LPA will be closing this facility with a closure date of today and Licensee will mail in their license for this facility to the Riverside Regional Office.

An exit interview was conducted with Licensee Montano Recinto wherein a copy of this report was provided.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira ArreolaTELEPHONE: 951-248-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2022
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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