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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881515
Report Date: 04/10/2024
Date Signed: 04/10/2024 02:12:45 PM

Document Has Been Signed on 04/10/2024 02:12 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:BETTER LIFE BOARD & CARE INCFACILITY NUMBER:
331881515
ADMINISTRATOR/
DIRECTOR:		MICHAELS, PAULFACILITY TYPE:
735
ADDRESS:29137 BLUESTONE DRTELEPHONE:
(951) 691-3935
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY: 4CENSUS: 0DATE:
04/10/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Applicant, Paul MichaelsTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Janira Arreola, made an announced visit to the facility in order to conduct a pre licensing inspection. LPA met with Applicant, Paul Michaels who was informed of the purpose of the visit.

The facility is seeking an initial license. The facility will be licensed as a adult residential facility, with capacity of (4) ambulatory clients. The facility does not have a pool or firearms. The home is a one story home with (4) bedrooms and (2) bathrooms.

LPA conducted a walk through of the interior and exterior of the facility. The bedrooms have all the required furniture, and required hygiene supplies, and linens. LPA observed the hallway lights and the carbon monoxide detectors were in good working condition. The outdoor area was free of any hazards and had a shaded area for residents and an emergency exit. The kitchen had the ability to prepared food is a clean and safe environment. LPA observed areas were the staff and resident files would be kept as well as locked areas designated for medication, sharp objects, and cleaning supplies. The hot water temp was measures at 111F. The facility has a land line at (951) 309-3231.

There are no objections for the applicant to proceed in the pre licensing process. An exit interview was conducted with the applicant, and copy of this report was reviewed and provided to them.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 04/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2024
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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