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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881250
Report Date: 02/09/2022
Date Signed: 02/09/2022 01:20:42 PM

Document Has Been Signed on 02/09/2022 01:20 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
RIVERSIDE, CA 92507
FACILITY NAME:HOME OF COMFORT LLCFACILITY NUMBER:
331881250
ADMINISTRATOR:HAWKINS, TASHAFACILITY TYPE:
735
ADDRESS:26545 ROLAND ROADTELEPHONE:
(951) 987-6069
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY: 4CENSUS: 0DATE:
02/09/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:11 PM
MET WITH:ADMINISTRATOR TASHA HAWKINSTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Venus Mixson met with administrator Tasha Hawkins for Pre-Licensing at 26545 Roland Rd. Murrieta CA. 92563. An application to license an Adult Residential Facility (ARF) was received by Centralized Applications Bureau (CAB) on Oct. 12, 2021, for a total four ambulatory beds. Fire Inspection was granted Nov.5, 2021, by Murrieta Fire & Rescue. LPA Mixson observed the following:
Structure: Was a single-story home with four bedrooms, two bathrooms, living /dining areas, spacious kitchen, and laundry area.
Heating/Cooling System: Central heating and air conditioning systems.
Bedrooms: Four (4) ambulatory residents. Bedrooms were adequately furnished with bed, appropriate linen, adequate lighting, and smoke detectors.
Bathrooms: Have a working toilet, wash basin, and shower with an adequate supply of towels, toilet paper, and toiletries. Water temperature measured between 105 & 110 F.
Kitchen/Laundry: Was adequately supplied with dishes, glasses, utensils, pots, and pans were observed. Cleaning supplies and knives/sharp instruments were secured and locked separately. There was adequate room for food storage. Refrigerator/freezer were in working condition and had sufficient storage for perishable food. Seating for meals was adequate.
Living/Family room(s): Has adequate seating and furnishings items appear to be in good repair.
Hygiene Supplies/Linens: Were adequate in supply, and there were enough linens to change throughout the week if needed.
Outside/Yards: No obstructions or bodies of water observed on the property.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2022
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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