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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881263
Report Date: 02/07/2025
Date Signed: 02/07/2025 01:41:02 PM

Document Has Been Signed on 02/07/2025 01:41 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:WE CARE LIVINGFACILITY NUMBER:
331881263
ADMINISTRATOR/
DIRECTOR:		DIMAURO, DAVIDFACILITY TYPE:
735
ADDRESS:31894 SILK VINE DRTELEPHONE:
(951) 501-6473
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY: 4CENSUS: 4DATE:
02/07/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:David DiMauro Sr.TIME VISIT/
INSPECTION COMPLETED:
01:45 PM
NARRATIVE
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On 02/07/2025 at 08:45 AM, Licensing Program Analyst (LPA) Melody Brown met with staff David DiMauro Sr. to initiate a Case Management Visit. The investigation consisted of observation, interviews, and a review of pertinent documentation.

During the facility visit today, 02/07/2025, LP) Melody Brown requested Client #1 (C1) facility file to review documents and LPA Brown observed that C1 does not have Medical Assessment/Physician Report (LIC602) on C1’s facility file. Licensee/Administrator DiMauro Jr. reported to LPA Brown that C1 does not have Medical Assessment or form LIC602 when C1 was placed at the facility by Inland Regional Center on 11/22/2024. LPA Brown explained to Licensee/Administrator DiMauro Jr. that deficiency will be issued as in Adult Residential Facility (ARF), the Licensee must obtain and keep on file documentation of the client’s medical assessment prior to accepting client into care. Licensee/Administrator DiMauro Jr. verbalized understanding. In addition, Licensee/Administrator DiMauro Jr. informed LPA Brown that Client #2 (C2) and Client #3 (C3) were placed at the facility by IRC as well without Medical Assessment/Physician Report (LIC602). Documents review confirmed that C2 was placed by IRC at the facility on 11/7/2024 without Medical Assessment or form LIC602 and C3 was placed by IRC at the facility on 01/21/2025 without Medical Assessment or form LIC602. In addition, LPA Brown noted during documents review that C1 does not have the required Admission Agreement maintained in C1 file. Deficiency will be issued.

Moreover, during the quick tour of the facility, LPA Brown observed one (1) sharp scissor, one (1) sharp wine opener, and seven (7) sharp corn cob holder not locked and accessible to clients in care. Deficiency will be issued. Staff DiMauro Sr. immediately locked the one (1) sharp scissor, one (1) sharp wine opener, and seven (7) sharp corn cob holder during the visit.

***Continuation in LIC809C***

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: WE CARE LIVING
FACILITY NUMBER: 331881263
VISIT DATE: 02/07/2025
NARRATIVE
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Furthermore, LPA Brown cross reference Guardian database and observed that Staff #1 (S1) has criminal background clearance but S1's criminal background clearance was not transferred to the facility prior to employment when the facility was licensed on 04/06/2022. Deficiency will be issued and a civil penalty of $500.00 will be assessed today and will continue to be assessed of $100.00 per day until corrected.

An exit interview was conducted where this report (LIC809), LIC809D and LIC421BG and Appeal Rights were discussed and provided to staff David DiMauro Sr.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 02/07/2025 01:41 PM - It Cannot Be Edited


Created By: Melody Brown On 02/07/2025 at 12:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: WE CARE LIVING
FACILITY NUMBER: 331881263

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/08/2025
Section Cited
CCR
80069(b)

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80069 Client Medical Assessment (b) In ARFs , prior to accepting a client into care, the licensee shall obtain and keep on file documentation of the client's medical assessment.
This requirement was not met as evidenced by:
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Licensee stated to train all staff on CCR 80069(b) and submit proof to LPA Brown by the Plan of Correction (POC) due date.
Licensee stated to provide proof of medical appointment to obtain C1, C2 and C3 medical assessment to LPA Brown by the POC due date.
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Based on observation, interview and records review, the Licensee did not comply with the section cited above by not ensuring that medical assessment was obtained prior to accepting Client #1 (C1), Client #2 (C2) and Client #3 (C3) into care which poses an immediate health, safety and personal rights risk to clients in care.
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Type A
02/08/2025
Section Cited
CCR80087(g)

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80087 Buildings and Grounds (g) Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement was not met as evidenced by:
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Licensee stated to train all staff on CCR 80087(g) and submit proof to LPA Brown by the POC due date.
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Based on observation, interview and records review, the Licensee did not comply with the section cited above by not ensuring that the one (1) sharp scissor, one (1) sharp wine opener, and seven (7) sharp corn cob holder were locked and not accessible to clients in care which poses an immediate health, safety and personal rights risk to clients in acre.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Efren Malagon
LICENSING EVALUATOR NAME:Melody Brown
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2025


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 02/07/2025 01:41 PM - It Cannot Be Edited


Created By: Melody Brown On 02/07/2025 at 12:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: WE CARE LIVING
FACILITY NUMBER: 331881263

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2025
Section Cited
CCR
80068(a)

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80068 Admission Agreements (a) The licensee shall complete an individual written admission agreement with each client and the client's authorized representative, if any.
This requirement was not met as evidenced by:
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Licensee stated to submit proof of C1's completed Admission Agreement to LPA Brown by the Plan of Correction (POC) due date.
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Based on observation, interview and records review, the Licensee did not comply with the section cited above by not ensuring that Client #1 (C1) has an Admission Agreement maintained in C1's file which poses a potential health, safety and personal rights risk to client in care.
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Type B
02/17/2025
Section Cited
CCR80019(e)(3)

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80019 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 80019(f) or
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Licensee stated to submit proof of S1's transferred criminal background clearance to LPA Brown by the POC due date.
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This requirement was not met as evidenced by: Based on observation, interview and records review, the Licensee did not comply with the section cited above by not ensuring that Staff #1 (S1) criminal background clearance was transferred to the facility prior to employment which poses a potential health, safety and personal rights risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Efren Malagon
LICENSING EVALUATOR NAME:Melody Brown
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2025


LIC809 (FAS) - (06/04)
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