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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881414
Report Date: 11/22/2024
Date Signed: 11/22/2024 12:13:03 PM

Document Has Been Signed on 11/22/2024 12:13 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:MORENO VALLEY RESOURCE CENTERFACILITY NUMBER:
331881414
ADMINISTRATOR/
DIRECTOR:
MARQUEZ, EDUARDOFACILITY TYPE:
775
ADDRESS:22620 GOLDENCREST DR STE D101TELEPHONE:
(951) 247-6077
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY: 75CENSUS: 18DATE:
11/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:52 AM
MET WITH:Aprille Vidal-Case Manager-Interm Program DirectorTIME VISIT/
INSPECTION COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) Debbie Palacios made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Case Manager (CM), Aprille Vidal who was informed of the purpose of the visit. The facility has a fire clearance for seventy five (75) ambulatory clients and 70 may be Non-ambulatory. Staff present have a criminal record clearance and are associated with the facility.

LPA toured the facility and reviewed records. During the tour, LPA observed the facility is a one story building center that has a section with tables and chairs for clients to do Arts and Crafts activities, table top games and range of motion exercises, interaction with peers. There is eighteen (18) clients and twelve (12) staff present in the facility. The facility has 5 restrooms and 2 changing rooms where staff change client's diapers every 2 hours or as needed. The facility has a kitchen/lunch area room with a locked closet where staff keeps the cleaning supplies and first aid kit. Facility has a locked food storage where they keep their emergency food. Staff reported that clients bring their own lunch but snacks are provided; staff has a snack menu posted in the kitchen wall. The facility has required furniture, lighting, and a locked closet storage for staff personal belongings and personal hygiene supplies. LPA also observed four (4) charged fire extinguishers mounted throughout the facility, last serviced on 11/7/24. Facility has multiple operating dual smoke alarms and carbon monoxide detector that meet statutory standards. The Facility has an LVN nurse onsite and in the nurse's office, medications are stored in a locked cabinet. LPA toured the facility's exterior and observed outdoor pathways were free of obstructions; there is three (3) emergency doors. LPA reviewed client files that had the required documents on file. Staff files reviewed had the Department's required training records and valid first aid/CPR certification.

Aprille was notified that CCLD has not received the facility's annual fee for 2024. LPA provided an email address cclwebmaster@dss.ca.gov for the facility to obtain the PIN number to pay the annual fee.

No deficiencies were observed during today's visit. An exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024
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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