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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881507
Report Date: 02/08/2024
Date Signed: 02/08/2024 04:14:24 PM


Document Has Been Signed on 02/08/2024 04:14 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:PATTY'S PLACEFACILITY NUMBER:
331881507
ADMINISTRATOR:BARR, BOBBI JEANFACILITY TYPE:
740
ADDRESS:25079 QUEBRADA COURTTELEPHONE:
(951) 750-8656
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:6CENSUS: 0DATE:
02/08/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:03 PM
MET WITH:ADMINISTRATOR, BOBBI JEAN BARRTIME COMPLETED:
04:18 PM
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On February 08, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived for a scheduled visit for the purpose of conducting a Pre-Licensing visit. LPA Mixson met with Licensee, Bobbi Jean Barr, introduced herself, and stated the purpose of the visit.

The location is a single-story home located at 25079 Quebrada Ct. Moreno Valley CA. 92557 and has three bedrooms, two full bathrooms, a living room, dining room, and a kitchen, with a three car garage. A backyard and front yard. The Riverside County Fire Department approved this facility for six Non-Ambulatory residents, on 11/07/2023. The home has a first aid kit and manual, the Administrator has received First Aid and CPR training, and the Administrator’s certificate is current. LPA Mixson observed where medications are to be stored, locked, and inaccessible to the residents. The home is equipped with lights in the passages and stocked with emergency night lights throughout the home. The smoke and carbon monoxide detectors were observed and are operable. LPA Mixson observed the fire extinguisher, it was charged and in the green, and obtained on 11/07/2023. The cleaning supplies were locked and inaccessible, along with the sharp objects and there are no fire arms on the premises at this time. The knives were locked in a kitchen drawer, plenty of pots, pans, and other kitchen accessories. The facility has the required seven day supply of non-perishable food items and the two day supply of perishable food items. LPA Mixson observed hygiene supplies for residents. All doors, and passageways are clear of obstruction. There were no bodies of water on the premises, and the fireplace was covered with a screen. There was enough clean linen and hygiene items, and there was appropriate lighting in each room. LPA Mixson observed central heating and air conditioning systems, and they are operable. The Administrator dialed the land line phone number (951) 924-6459, and it was operable. Outside/Yards: Had shade and covering for shaded visits, and activities. There were no obstructions observed. The Licensee stated there were no firearms, and/or ammunition on the premises.
CAB 8.0 Pre-licensing / COMP III Requested and to be scheduled. An exit interview was conducted, a copy of this report was provided to the Licensee, Bobbi Jean Barr.
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus MixsonTELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2024
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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