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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880734
Report Date: 03/17/2023
Date Signed: 03/17/2023 11:22:52 AM


Document Has Been Signed on 03/17/2023 11:22 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:RANCHO MIRAGE TERRACEFACILITY NUMBER:
331880734
ADMINISTRATOR:MARIGER, VICKIFACILITY TYPE:
740
ADDRESS:34560 BOB HOPE DRIVETELEPHONE:
(760) 770-7737
CITY:RANCHO MIRAGESTATE: CAZIP CODE:
92270
CAPACITY:142CENSUS: 107DATE:
03/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Monique Moreira, Executive DirectorTIME COMPLETED:
11:35 AM
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On March 17, 2023, Licensing Program Analysts (LPAs) Chinwe Nwogene and Kathleen Banrasavong arrived unannounced to the facility to conduct a case management visit regarding an eviction process taking place.

During the visit, staff and resident were interviewed, resident file and facility record was reviewed to make sure the eviction process is in compliance with Title 22, California Code of Regulations.

No deficiencies noted at the time of visit. An exit interview was conducted, and a copy of this report was reviewed with and provided to Monique Moreira.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Chinwe NwogeneTELEPHONE: (951) 202-2066
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2023
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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