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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880812
Report Date: 01/17/2025
Date Signed: 01/17/2025 03:49:45 PM

Document Has Been Signed on 01/17/2025 03:49 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 ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:RIVERWALK VISTA SENIOR CARE LLCFACILITY NUMBER:
331880812
ADMINISTRATOR/
DIRECTOR:		VALENZUELA, MYRNA DFACILITY TYPE:
740
ADDRESS:10831 PORTOFINO LANETELEPHONE:
(951) 729-6243
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
01/17/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Administrator, Oliver HuertoTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Administrator, Oliver Huerto who was informed of the purpose of the visit. At time of visit there were (6) clients and (2) staff present.

The facility is a one story home with (5) bedrooms and (2) bathrooms with attached garage. The facility does not have a pool or fire arms. LPA was informed that the facility has been sold and is undergoing a change in ownership process. The licensee, stated they would submit missing documents to Central Applications Bureau (CAB) by the due dates given.

Infection Control: LPA observed hand hygiene supplies, PPE equipment and cleaning supplies to do regular cleaning of the facility within the infection control measures.

Physical Plant: Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were present and in good repair. The facility's outdoor area was observed to be free of hazards. Laundry equipment was observed to be in good working condition. The carbon monoxide detector was tested and operational during the visit. The hot water temperature was read at the required range.
Tricia DanielsonTELEPHONE: (951) 202-5067
Janira ArreolaTELEPHONE: 951-233-6759
DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: RIVERWALK VISTA SENIOR CARE LLC
FACILITY NUMBER: 331880812
VISIT DATE: 01/17/2025
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Record Review and Resident/Staff Files: LPA reviewed (5) staff files and training and (5) Client files were reviewed and possessed the required paperwork.

Health Related Services/ Incidental Medical Services: All client medication was locked in hallway cabinet. LPA reviewed client medications were accounted for on the centrally steered lists.

Disaster preparedness: The facility has an emergency and disaster plan and last fire drill conducted on 01/06/2025. The facility had emergency supplies such as a first aide kit and exits were free of obstructions.

The current administrator meets the administrator requirements and has an up to date certificate. Staff schedule was reviewed, and staffing levels were observed during the time of the visit. The Facility's liability insurance was reviewed and was within date at the time of the visit.

No deficiencies were cited at the time of the visit. An exit interview was conducted where a copy of this report was reviewed and provided.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira ArreolaTELEPHONE: 951-233-6759
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
LIC809 (FAS) - (06/04)
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