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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881091
Report Date: 12/06/2023
Date Signed: 12/06/2023 10:08:31 AM

Document Has Been Signed on 12/06/2023 10:08 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 AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:ASTRO CONCEPTS CARE LLCFACILITY NUMBER:
331881091
ADMINISTRATOR:NATALIE MARCAIDAFACILITY TYPE:
735
ADDRESS:27710 BLUE TOPAZ DR.TELEPHONE:
(323) 217-3261
CITY:MENIFEESTATE: CAZIP CODE:
92585
CAPACITY: 6CENSUS: 3DATE:
12/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Omobola Akanni, Care ProviderTIME COMPLETED:
10:10 AM
NARRATIVE
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Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived unannounced to conduct a Case Management visit regarding CCLD receiving information about a client in care. LPA was greeted by caregiver, Omotola Akanni and the purpose of the visit was explained.

LPA interviewed staff and residents, and obtained a copy of the client roster. LPA also spoke with Administrator Natalie Marcaida by telephone. LPA did not obtain any information regarding the client in care. LPA also conducted a health and safety check. No deficiencies were observed.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Jacqueline Shaw Ross
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2023
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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