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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880784
Report Date: 02/07/2022
Date Signed: 02/07/2022 02:00:32 PM

Document Has Been Signed on 02/07/2022 02:00 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:AUBREY'S VILLASFACILITY NUMBER:
331880784
ADMINISTRATOR:JOSEPH JHAY GATUSFACILITY TYPE:
740
ADDRESS:68640 SENORA ROADTELEPHONE:
(760) 832-7884
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY: 6CENSUS: 6DATE:
02/07/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Jonie Gatus - LicenseeTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Crystal Colvin conducted an unannounced case management visit in order to increase the capacity per licensee request. LPA Colvin met with Licensee Jonie Gatus and explained the purpose of the visit.

Licensee requested for a capacity increase from 6 residents to 10 residents, which includes an increase from 1 bedridden to 2 bedridden, and all residents able to be non-ambulatory. A Fire Clearance was approved on 1/24/22 for 8 non-ambulatory residents and 2 bedridden residents, for a total of 10 residents. Facility sketch on file shows sufficient square footage in the facility and activity rooms to accommodate the requested capacity. LPA Colvin discussed the facility sketch with Licensee as well as the proposed changes to the capacity of the residential building. Resident bedrooms #5 & #6 have been approved for bedridden residents, and LPA Colvin confirmed that both bedrooms have an exit to the outside of the facility, as well as a walk-in shower in the private bathrooms. LPA Colvin and toured the interior/exterior of the building and visually inspected the resident bedrooms. LPA Colvin confirmed that all identified shared rooms are large enough to accommodate the required furniture for two residents without inhibiting movement into and throughout the rooms. LPA Colvin additionally confirmed that there are sufficient bathrooms in the facility to meet Title 22 requirements for ratio of residents to bathrooms.

The physical plant is ready for increase in capacity. LPA Colvin has notified the Licensee of final capacity increase approval. LPA Colvin further advised the Licensee that the new license will follow in the mail after capacity increase visit.

An exit interview was conducted where this report was discussed and a copy was provided to Licensee Jonie Gatus.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2022
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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