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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880947
Report Date: 08/29/2024
Date Signed: 08/30/2024 08:11:58 AM

Document Has Been Signed on 08/30/2024 08:11 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:ROY'S DESERT SPRINGS ADULT RESIDENTIAL CAREFACILITY NUMBER:
331880947
ADMINISTRATOR/
DIRECTOR:		ALEXANDER OGLEFACILITY TYPE:
735
ADDRESS:19531 MCLANE STTELEPHONE:
(760) 778-2083
CITY:NORTH PALM SPRINGSSTATE: CAZIP CODE:
92258
CAPACITY: 92CENSUS: 91DATE:
08/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Adminstrator Alex OlgeTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
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On 8/29/24 Licensing Program Analyst's (LPAs) Valerie Flores, Andrei Castillo and Abdoulaye Zerbo conducted an unannounced one (1) year required visit. LPA's were granted entry by staff, Maria Camacho, who was informed of the purpose of visit. All staff present were observed to have obtained proper fingerprint clearance and were associated to the facility. LPA's observed the following during today's visit:

LPA's conducted a tour of the facility with Program Manager, Keta Abner. The Licensee is operating the facility within the conditions and limitations specified on the license. Resident bedrooms had the required bedding, furniture, and lighting. Toilets, hand washing and bathing facilities were kept safe, sanitary, and in operating condition. The facility is being maintained at a comfortable temperature. Indoor and outdoor passageways were free of obstruction. There were no bodies of water located on the property. The facility has more than a two (2) day supply of perishable foods and seven (7) day supply of non-perishable foods. Dishes and utensils were in sufficient supply and in good repair. Extra linen and towels were observed to be sufficient in supply and in good repair. According to staff, there are no firearms or ammunition on the premises. Cleaning supplies and disinfectants were observed in a locked janitorial room. Facility maintained the centrally stored medication in a locked room only accessible to staff. Charged fire extinguishers were mounted throughout the facility.



Staff files reviewed included but not limited to criminal record clearance, health screenings, personnel records and valid first aid/CPR certification. Resident files included but are not limited to signed admission agreements, appraisals, needs and service plans, and physician reports. Medical records reviewed showed no discrepancies. Facility sketch, personal rights, see something say something and emergency disaster plan is posted in the hallway near the entrance. During today's visit, LPA's did not observe any immediate violations or concerns.

An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator, Alex Olge.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
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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