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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881147
Report Date: 11/30/2023
Date Signed: 11/30/2023 01:31:58 PM


Document Has Been Signed on 11/30/2023 01:31 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:TRINITY WAY ASSISTED LIVING FACILITYFACILITY NUMBER:
331881147
ADMINISTRATOR:HAMILTON LIGON, KIMBERLY DFACILITY TYPE:
740
ADDRESS:7015 COLLEGE PARK DRIVETELEPHONE:
(323) 806-2313
CITY:CORONASTATE: CAZIP CODE:
92880
CAPACITY:6CENSUS: 0DATE:
11/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:27 PM
MET WITH:Kimberly Hamilton, LicenseeTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Amy Goldenberg arrived to the facility to conduct an annual required visit. LPA met with Kimberly Hamilton Ligon, Licensee. LPA learned that the facility has never retained any residents and currently has no plan to take in any residents in the near future. Kimberly agrees that she will notify LPA prior to accepting any residents to have the facility reassessed for compliance at that time.
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Amy GoldenbergTELEPHONE: (951) 201-3990
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023
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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