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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881423
Report Date: 06/16/2023
Date Signed: 06/16/2023 11:48:13 AM

Document Has Been Signed on 06/16/2023 11:48 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
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:ALWAYS HEARTFELT HOMESFACILITY NUMBER:
331881423
ADMINISTRATOR:WILSON, UNIKKAFACILITY TYPE:
740
ADDRESS:42165 PATTON PLACETELEPHONE:
(310) 597-2688
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY: 6CENSUS: 3DATE:
06/16/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Unikka WilsonTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Sara Martinez conducted an announced visit to complete the Pre-licensing inspection. LPA met with Licensee, Unikka Wilson, for Residential Care Facility for the Elderly for one (1) ambulatory and four (4) non-ambulatory, and one (1) bedridden. The fire clearance was approved on 05/18/2023.

Unikka Wilson bought this facility from a previous licensee with the facility's name being "A Heartfelt Homes II" on May 20th 2022. There are currently three (3) residents and four (4) staff at this facility. 3 staff members have background clearance and are associated with previous facility "A Heartfelt Homes II". Staff # 1 (S1) is not associated but has been confirmed to have a background clearance and an attempt to associate S1 to this facility.

The facility is a six (6) bedroom, three (3) bath home. There are five (5) client bedrooms, one (1) staff bedroom, one (1) staff office, kitchen/dining area, one (1) living room areas, a laundry room, backyard with a sunroom. LPA toured the interior and exterior areas of the facility. The following were inspected:



Client Bedrooms: All bedrooms have the required bedding and furniture, such as, clean mattresses/linen, nightstands, dressers, chairs, and lighting.

Client Bathrooms: The bathroom appliances were operating in safe and sanitary condition. The water temperature was measured by LPA, the thermometer read at 118 degrees F.

CONTINUED ON 809-C...
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2023
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
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ALWAYS HEARTFELT HOMES
FACILITY NUMBER: 331881423
VISIT DATE: 06/16/2023
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Kitchen and Dining Areas: Utensils and dishware are in good repair and ready for client use. Kitchen appliances and counter top were free of debris and in good repair. LPA observed this facility met the minimum requirement for 2-day worth of perishables and 7-day worth of non-perishable food. The sharp knives and chemicals were locked under the kitchen sink. The centrally stored medication was locked up in a cabinet in the dinning room and PRN intake was being documented.

Common Sitting Areas: There is adequate seating in the common areas. The facility has a supply of activities for the clients.

Laundry Room: The laundry room is located next to the kitchen/dinning room. The chemicals and laundry soap were safely locked in this room.



Linens and Hygiene Supplies: An adequate supply of linens were available and there was plenty hygienic product readily available.

Backyard: There are no bodies of water in the backyard. There is a covered area with seating for the all the clients. All passageways were free from obstruction.

Fire extinguisher, carbon monoxide, firearms: There were two (2) charged fire extinguishers in the facility. LPAs observed operating smoke detectors and carbon monoxide alarms. The home does not have any firearms and ammunition. The facility was equipped with a complete first aid kit and manual. The facility has working telephone for client use.

Postings: LPAs observed required postings including the visitation polices, emergency/disaster plans, complaint procedures, and personal rights.

LPAs observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPAs have determined that the facility meets the operational requirements for licensure. The Pre-licensing inspection is complete, and this facility has no deficiencies. The facility has satisfied all requirements in accordance with Title 22, California Code of Regulations.

An exit interview was conducted, and this report was discussed and provided to Licensee Unikka Wilson.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2023
LIC809 (FAS) - (06/04)
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