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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880815
Report Date: 10/19/2022
Date Signed: 10/19/2022 02:04:34 PM


Document Has Been Signed on 10/19/2022 02:04 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
, CA 92507



FACILITY NAME:A TENDER TOUCH SENIOR LIVING LLCFACILITY NUMBER:
331880815
ADMINISTRATOR:MOJICA, FLORENCE AFACILITY TYPE:
740
ADDRESS:1651 ROSE AVENUETELEPHONE:
(310) 532-5338
CITY:BEAUMONTSTATE: CAZIP CODE:
92223
CAPACITY:6CENSUS: 6DATE:
10/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:14 PM
MET WITH:Florance Mojica Administrator TIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to the facility to initiate annual inspection, LPA was greeted and granted entrance to the facility by caregiver Imelda Majam who called Florance Mojica- Administrator.

LPA observed that the facility has a mitigation plan to mitigate the spread of COVID-19 in the facility. One central entry point and sign-in policy has been designated for universal entry screening. Routine symptom screening has been initiated at entry for all staff, clients, and visitors. Facility also documents daily temperature and COVID-19 symptom checks, and any change in condition for staff and clients.

LPA toured the facility inside and out and there were no health and safety concerns. The facility has charged fire extinguishers, operating smoke alarms, and carbon monoxide detectors.

The outdoor and indoor hallways were also free of obstruction.

Cleaning supplies are locked in a cabinet in the laundry area

LPA’s observed a two (2) day supply of perishable food items and seven (7) day supply of non-perishable food items. The facility menu was available for review.

The client rooms had the required furniture and sufficient lighting. The bathrooms can accommodate the needs for bathing and showers/tubs with non-slip flooring. The facility had a supply of additional linen and extra hygiene items for the clients.

LPA measured the hot water temperature 105.8 F. in the bathroom at the entry point of the home.

Based on interviews and observations made during today’s inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report was discussed, and a copy was provided to Florance Mojica at the conclusion of the visit.

SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette AllenTELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022
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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