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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880891
Report Date: 05/17/2022
Date Signed: 05/17/2022 09:30:13 AM

Document Has Been Signed on 05/17/2022 09:30 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:REAL WORLD CARE HOUSEFACILITY NUMBER:
331880891
ADMINISTRATOR:YLARDE, MARLYNFACILITY TYPE:
735
ADDRESS:2008 PRINCE ALBERT DRTELEPHONE:
(310) 334-9013
CITY:RIVERSIDESTATE: CAZIP CODE:
92507
CAPACITY: 5CENSUS: 0DATE:
05/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Property Owner Steve MuchnickTIME COMPLETED:
09:40 AM
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Licensing Program Analyst (LPA) Jesse Gardner arrived at the facility to conduct an Annual/Required Visit with an emphasis on infection control. Property Owner Steve Muchnick answered the door and LPA identified himself and was allowed into the facility.

Muchnick stated there are still currently no residents in care as the facility is going through the vendorization process with Inland Regional Center (IRC). Muchnick accompanied LPA on a tour of the inside and outside of the facility.

LPA inspected the inside and outside of the facility and verified there are no clients in care. LPA toured the bedrooms, the bathrooms, and went over the facilities infection control procedures with Muchnick. Muchnick was instructed to inform LPA once the vendorization is final, and the first client is placed in the facility.

An exit interview was conducted and a copy of this report was provided to Property Owner Steve Muchnick. No technical violations or citations are being given at this time.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022
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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