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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881378
Report Date: 10/11/2022
Date Signed: 10/11/2022 03:27:34 PM


Document Has Been Signed on 10/11/2022 03:27 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:DESERT HOPE ELDERLY CAREFACILITY NUMBER:
331881378
ADMINISTRATOR:FLORES, DENISEFACILITY TYPE:
740
ADDRESS:1 CALAIS CIRCLETELEPHONE:
(760) 702-1151
CITY:RANCHO MIRAGESTATE: CAZIP CODE:
92377
CAPACITY:6CENSUS: 3DATE:
10/11/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Cynthia, Monica and Dinma Chicas, ApplicantsTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA), Stephanie Torres, conducted an announced pre-licensing inspection at the facility. The LPA met with Applicants, Cynthia, Monica and Dinma Chicas. There are currently three (3) residents in care.

Application: The application is for a Residential Care Facility for the Elderly, change of ownership. The fire clearance has been granted for six (6) non-ambulatory residents.

Buildings and Grounds: The home is composed of four (4) resident bedrooms, two (2) staff quarters, two and a half (1/2) resident bathrooms, garage, laundry room, two living rooms, a kitchen and dinning areas, 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. A pool is located on the premises and is appropriately secured. According to Cynthia Chicas, there are no weapons stored in the home. Rooms, furniture, beds, mattresses are all in good repair. The bedrooms are furnished and privacy is available. The dining and living room areas are clutter free and furniture is in good condition. The resident bathroom was observed to have non-slip mats available. The hot water was tested and measured at 118.4 degrees Fahrenheit, which is within regulatory limits. Outdoor areas had sufficient room for activities. A washing machine and dryer are available and in working order.

Storage and Supplies: Activities were observed to be available. Medications will be stored inaccessible to any unauthorized individuals. Designated areas are available for facility files and resident files. The first aid kit was observed to be available and complete. Cleaning supplies will be stored away in a locked area. Linens, and equipment are all in good repair and sufficient for approved census. Several Fire extinguishers were available and fully charged.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2022
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 2


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: DESERT HOPE ELDERLY CARE
FACILITY NUMBER: 331881378
VISIT DATE: 10/11/2022
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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 pantry, available only to authorized individuals.

Forms: The following signs were observed to be posted at the home: Theft and Loss Policies, Personal Rights, Resident/Family Councils, and Complaint Information.

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 applicants.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2