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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880802
Report Date: 05/30/2023
Date Signed: 05/30/2023 10:54:01 AM


Document Has Been Signed on 05/30/2023 10:54 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:MURRIETA GARDENSFACILITY NUMBER:
331880802
ADMINISTRATOR:NIARE FEASTERFACILITY TYPE:
740
ADDRESS:24200 MONROE AVETELEPHONE:
(951) 600-7676
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:72CENSUS: 50DATE:
05/30/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Brittany Kavanaugh, Executive DirectorTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Javina George conducted an unannounced visit to the facility on May 30, 2023. The purpose was to amend complaint control #18-AS-20210909111310.


An exit interview was conducted and a copy of this report was provided to Brittany Kavanaugh, Executive Director.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina GeorgeTELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
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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