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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
331880784
Report Date:
06/15/2023
Date Signed:
06/15/2023 02:03:24 PM
Document Has Been Signed on
06/15/2023 02:03 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
RIVERSIDE AC/SC
,
1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE
,
CA
92507
FACILITY NAME:
AUBREY'S VILLAS
FACILITY NUMBER:
331880784
ADMINISTRATOR:
JOSEPH JHAY GATUS
FACILITY TYPE:
740
ADDRESS:
68640 SENORA ROAD
TELEPHONE:
(760) 832-7884
CITY:
CATHEDRAL CITY
STATE:
CA
ZIP CODE:
92234
CAPACITY:
10
CENSUS:
9
DATE:
06/15/2023
TYPE OF VISIT:
Case Management - Health Checks
UNANNOUNCED
TIME BEGAN:
12:42 PM
MET WITH:
Administator, Jonieanne Franciscogatus
TIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Kathleen Banrasavong made an unannounced visit to conduct a health and safety inspection. There were no concerns observed at this time. Annual is due in October.
SUPERVISORS NAME
:
Jazmond D Harris
LICENSING EVALUATOR NAME
:
Kathleen Banrasavong
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/15/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/15/2023
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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