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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881492
Report Date: 03/12/2025
Date Signed: 03/12/2025 01:49:07 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/12/2025 01:49 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:LUCENA ARF #2FACILITY NUMBER:
331881492
ADMINISTRATOR/
DIRECTOR:		LUCENA, VANESSAFACILITY TYPE:
735
ADDRESS:14497 PHILO STTELEPHONE:
(951) 330-1991
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 4CENSUS: 0DATE:
03/12/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Licensee, Anthony AlonzoTIME VISIT/
INSPECTION COMPLETED:
01:55 PM
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Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced visit to the facility for the required annual visit. LPA met and was granted entry by live in staff, and was later met by the Licensee, Anthony Alonzo. LPA conducted a tour of the inside and outside of the home, checked the hot water, and the smoke alarms.

LPA observed there are no clients residing in the home, no client records, or medications. LPA conducted a review of the Guardian roster and confirmed staff present are cleared to be at the facility.

No health or safety issues were observed at the time of the visit. No deficiencies were cited. A copy of this report was reviewed and provided to the Licensee.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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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