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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880734
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:32:10 PM


Document Has Been Signed on 01/12/2023 01:32 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:GLADWELL RANCHO MIRAGEFACILITY NUMBER:
331880734
ADMINISTRATOR:MARIGER, VICKIFACILITY TYPE:
740
ADDRESS:34560 BOB HOPE DRIVETELEPHONE:
(760) 770-7737
CITY:RANCHO MIRAGESTATE: CAZIP CODE:
92270
CAPACITY:142CENSUS: 108DATE:
01/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Sandra Zendejas, Business DirectorTIME COMPLETED:
01:40 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) Jesse Gardner arrived unannounced to conduct a case management visit to follow up on information that the Department needed. LPA met with Business Director Sandra Zendejas and toured the facility.

LPA advised Zendejas that an updated LIC500 is needed by CCL and to provide to LPA by January 17, 2023.

Upon review of the facility roster found in Guardian, LPA noted that Assistant Executive Director (Interim Administrator) April Princesa was not associated to Gladwell Rancho Mirage. Princesa began employment in mid November, 2022, and is at the facility on Tuesday, and Wednesday's, and some weeks it rotates to Wednesday, Thursday's. Princesa was not on property at the time of visit. Deficiency was cited per Title 22.

No other citations were noted on today's visit.

An exit interview was conducted where a copy of this report was discussed and provided along with the LIC809-D, LIC421-BG, and Appeal Rights.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Jesse GardnerTELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023
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 2


Document Has Been Signed on 02/29/2024 11:36 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 02/15/2024 01:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507


FACILITY NAME: GLADWELL RANCHO MIRAGE
FACILITY NUMBER: 331880734

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
01/13/2023
Section Cited
CCR
87411(g)(2)

1
2
3
4
5
6
7
Personnel Requirements: (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall:(2) Request a transfer of a criminal record clearance as specified in Section 87355(c). This was not being met as evidenced by:
1
2
3
4
5
6
7
Licensee agrees to transfer Princesa to Gladwell Rancho Mirage and submit proof of such to LPA by POC date.
8
9
10
11
12
13
14
Based on LPA's record review of the clearance roster, S1 was not found to be associated to Gladwell Rancho Mirage. This poses a potential health and safety and personal rights risk to residents in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Rikesha StampsTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Crystal ColvinTELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2