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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881625
Report Date: 01/22/2025
Date Signed: 01/22/2025 11:17:58 AM

Document Has Been Signed on 01/22/2025 11:17 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 ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:NURTURING CARE LLCFACILITY NUMBER:
331881625
ADMINISTRATOR/
DIRECTOR:		BARNES, JANICEFACILITY TYPE:
735
ADDRESS:1462 NUTMEY LANETELEPHONE:
(714) 341-9118
CITY:HEMETSTATE: CAZIP CODE:
92545
CAPACITY: 4CENSUS: DATE:
01/22/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Lorraine Von Deauxplette-Staff MemberTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Debbie Palacios conducted an announced visit to the pending facility to conduct a pre-licensing inspection. LPA met with Applicant/Licensee Dijon Washington, Chris Washington and Staff member Lorraine Von Deanxplette. Fire clearance has been granted for four (4) ambulatory clients and the facility will serve adults ages 18 through 59.

LPA conducted a tour of the facility’s interior and exterior. LPA did not observe any clients residing in the home or evidence to suggest the home is currently occupied. The facility is made up of a one-story home with four (4) client bedrooms, two (2) client bathrooms, a kitchen, living/family room, laundry room and garage. LPA did not observe bodies of water on the premises. The physical plant is in good repair. Indoor and outdoor passageways are free of obstruction. An outdoor shaded seating area is available for future clients. LPA observed two (2) charged fire extinguishers mounted throughout the facility; one (1) is located in the kitchen and the second one in the garage dated 08/22/24. LPA tested the smoke alarms and carbon monoxide detectors and found them to be operational. The facility also has a working telephone. LPA observed a locked closet in the hallway area for client files, cleaning solutions, centrally stored medications, and knives/sharp instruments.


Client bedrooms had the required bedding, furniture, closet storage, and functional lighting. Additional linen and towels are available for future clients.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: NURTURING CARE LLC
FACILITY NUMBER: 331881625
VISIT DATE: 01/22/2025
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Continued from LIC809.

LPA toured the kitchen and observed that food was stored in a safe and healthful manner. The facility had a 7-day supply of nonperishable food items in the kitchen pantry.

LPA toured the bathrooms and observed bathrooms to be in safe and sanitary conditions. The hot water temperature in the client bathrooms measured at 105-degrees Fahrenheit. LPA observed new hygiene kits stored in the laundry cabinets.

Living/family room has adequate seating in common areas. Fireplace in the dinning room has an appropriate barrier.

Emergency disaster plans, personal rights, and complaint procedures were posted in living/family room wall. LPA observed a complete first aid kit and manual. Staff and Client files to be secured in a locked cabinet in the hallway near the dinning area.

During today’s visit, LPA did not observe any issues or concerns. Licensee will complete COMP III and final approval of licensure will be granted by the Centralized Application Bureau analyst.



An exit interview was conducted where a copy of this report was discussed and provided.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
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