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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880734
Report Date: 02/29/2024
Date Signed: 02/29/2024 11:36:33 AM


Document Has Been Signed on 02/29/2024 11:36 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:RANCHO MIRAGE TERRACEFACILITY NUMBER:
331880734
ADMINISTRATOR:MONIQUE MOREIRAFACILITY TYPE:
740
ADDRESS:34560 BOB HOPE DRIVETELEPHONE:
(760) 770-7737
CITY:RANCHO MIRAGESTATE: CAZIP CODE:
92270
CAPACITY:142CENSUS: 122DATE:
02/29/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Monique Moreira - Executive DirectorTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Crystal Colvin arrived unannounced to conduct a case management visit to obtain signatures for an amended case management report deficiency page dated 1/12/23. LPA met with Executive Director Monique Moreira and advised them of the purpose of today’s visit.

No other citations were noted on today's visit.

An exit interview was conducted with Executive Director Monique Moreira and a copy of this report and amended LIC809D from 1/12/23 was provided.

SUPERVISOR'S NAME: Rikesha StampsTELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Crystal ColvinTELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024
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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