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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881263
Report Date: 08/15/2023
Date Signed: 08/15/2023 02:21:25 PM

Document Has Been Signed on 08/15/2023 02:21 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:WE CARE LIVINGFACILITY NUMBER:
331881263
ADMINISTRATOR:DIMAURO, DAVIDFACILITY TYPE:
735
ADDRESS:31894 SILK VINE DRTELEPHONE:
(951) 501-6473
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY: 4CENSUS: 4DATE:
08/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:David Dimauro, LicenseeTIME COMPLETED:
02:30 PM
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Licensing Program Analyst, Amber Coleman, (LPA) arrived at the We Care Living Adult Residential Facility unannounced to conduct an Annual Inspection. LPA was greeted by Licensee, David Dimauro. LPA introduced self and stated purpose of the visit. LPA was granted entry and provided space to work.

The facility has 4 resident bedrooms, 1 staff room, 2 bathrooms, kitchen, dining area, den (staff office), laundry room, living room, attached garage, and backyard. The facility is currently vendorized with the Inland Regional Center, (IRC) and designated Level 3. LPA conducted a general overall inspection, which included, but was not limited to, the following:

Physical Plant: The facility is operating at the capacity approved by Community Care Licensing (CCL). Pathways were observed to be free of obstruction. The facility was observed in comfortable temperature.. LPA inspected resident bedrooms and found that each room included required furniture such as: mattresses, night stands, adequate storage and sufficient lighting. LPA inspected resident bathrooms; 1 bathroom is for staff; attached to Master Bedroom. 1 bathroom is for residents. Bathrooms were observed to be clean and appliances functional. Water temperatures tested within regulated limits. The facility is equipped with operational smoke detectors and carbon monoxide alarms. Administrator reports fire drills are conducted on a monthly basis. Earthquake drills are conducted on a quarterly basis. Posters such as; the personal rights, letusknow, and disaster/evacuation plans were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were observed to be kept secure and inaccessible to residents in care. There was a designated secure storage space for resident/staff files in the staff office (den) Medications were secure and inaccessible to residents. Emergency and first aid kits were observed and readily available for residents in care. Fire extinguisher last inspected June 2023. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care.

Please LIC9099C
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: WE CARE LIVING
FACILITY NUMBER: 331881263
VISIT DATE: 08/15/2023
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Food Service: Non-perishable and perishable food supply is adequate for number of residents in care. 1 refrigerator and 1 deep freezer in the garage. Facility offers its resident a variety of food items. Dishes, cups, and utensils were observed in proper storage and in adequate amounts. Emergency food and water supply were also observed.
Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members currently employed in the facility have criminal record clearance through the department.
Record Review: LPA reviewed 2 resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed 2 staff file for First Aid/CPR certification, criminal record clearance, training, and health screenings.

Based on observations, interviews and record reviews no deficiencies will be cited per Title 22, California Code of Regulations. A copy of this report was read/reviewed with Facility Representative; signature acknowledges understanding and receipt of report and attachments.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC809 (FAS) - (06/04)
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