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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881346
Report Date: 10/03/2022
Date Signed: 10/14/2022 09:12:00 AM

Document Has Been Signed on 10/14/2022 09:12 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:PARADISE LIVING HOMESFACILITY NUMBER:
331881346
ADMINISTRATOR:BOWSER, JARASION C.FACILITY TYPE:
735
ADDRESS:37961 VERANDA WAYTELEPHONE:
(619) 508-3597
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY: 4CENSUS: 0DATE:
10/03/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Jarasion Bowser, ApplicantTIME COMPLETED:
05:30 PM
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Licensing Program Analyst (LPA), Stephanie Torres, conducted an announced pre-licensing inspection at the facility. The LPA met with Applicant, Jarasion Bowser. There are currently no clients in care.

Application: The application is for a new Adult Residential Facility (ARF). The fire clearance has been granted for four (4) ambulatory clients.

Buildings and Grounds: The home is composed of four (4) client bedrooms, two (2) bathrooms, two (2) sitting rooms, a laundry area, kitchen and dining area, a recreational area, garage, and front/back yard areas. The interior/exterior walkways of the home were observed to be clutter free with no obstructions present. Smoke and Carbon Monoxide detectors were tested and operable. There are no pools or other bodies of water located at the home. According to Bowser, there are no weapons stored in the home. Rooms, furniture, beds, mattresses appeared to be in good repair. The bedrooms are fully furnished, and privacy is available. The dining and living room areas are clutter free and in good condition. Outdoor areas had sufficient room for activities and leisure. A washing machine and dryer are available and in working order.

Storage and Supplies: Medications will be stored in a locked cabinet, inaccessible to any unauthorized individuals. Secured areas are available for facility files and client files. The first aid kit was observed to be available and complete. Cleaning supplies will be stored away in a secured kitchen cabinet. Linens, towels and other equipment appeared to be in good repair and sufficient for the approved census. Fire extinguishers were available and fully charged.

Food Service: Utensils and dishware are sufficient for the requested capacity. The refrigerator and stove are in working order. Sharps will be stored in a locked kitchen cabinet, available only to authorized individuals.

Forms: The following signs were observed to be posted at the home: Emergency Disaster Plan (LIC 610E),
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Stephanie Torres
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2022
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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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
RIVERSIDE, CA 92507
FACILITY NAME: PARADISE LIVING HOMES
FACILITY NUMBER: 331881346
VISIT DATE: 10/03/2022
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Personal Rights, Facility Sketch (LIC 999), Complaint Poster, and Visitors Policy.

No needed corrections were observed at time of visit. The LPA will inform the Centralized Applications Bureau (CAB) the home is ready for licensure. This report was discussed with and a copy provided to the applicant.

NOTE: Due to computer malfunction, this report was recreated and is an exact copy.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Stephanie Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC809 (FAS) - (06/04)
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