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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 335530176
Report Date: 03/03/2025
Date Signed: 03/03/2025 12:57:52 PM

Document Has Been Signed on 03/03/2025 12:57 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
, CA 92507
FACILITY NAME:WE CARE LIVING IIFACILITY NUMBER:
335530176
ADMINISTRATOR/
DIRECTOR:		MAURO, DAVID DIFACILITY TYPE:
735
ADDRESS:35653 CHANTILLY CTTELEPHONE:
(951) 501-6473
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY: 4CENSUS: 4DATE:
03/03/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Licensee/Administrator David DiMauro, Jr.TIME VISIT/
INSPECTION COMPLETED:
01:05 PM
NARRATIVE
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On 03/03/2025 at 08:45 AM, Licensing Program Analyst (LPA) Melody Brown conducted an unannounced visit to the facility to complete the required comprehensive annual inspection. LPA Brown was greeted by a Licensee/Administrator friend and gained access at the home. Licensee/Administrator David DiMauro, Jr. was contacted and informed of the visit. LPA Brown explained the purpose of the visit to Licensee/Administrator David DiMauro, Jr.

The facility has five (5) bedrooms, three (3) bathrooms, kitchen, dining room, living room, attached garage, and backyard. The facility is level 3 vendorized by Inland Regional Center (IRC). LPA Brown completed a walkthrough of the facility, review of records, medications audit and Personal & Incidental (P&I) audit.



Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD), LPA Brown observed no clients during the visit, as they were out in the community. There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 71 degrees Fahrenheit. LPA Brown inspected client bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs, and sufficient lighting. LPA Brown inspected client bathrooms; bathrooms were clean, and appliances were found functional. Water temperature tested at 114.6 degrees Fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide detectors, charged fire extinguishers, and first aid kit with first aid book.

Posters such as the personal rights, CCLD complaint poster, and emergency disaster plan, House Rules, Visitation Policy were posted in a common area. Client medications were kept in secure closet inaccessible to clients. LPA Brown observed no night lights maintained in hallway and passage to ground floor shared bathroom. Technical Violation issued. The facility have emergency kits, emergency food and water. There are no firearms and ammunition in the facility. *** Continuation in LIC809C *
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: WE CARE LIVING II
FACILITY NUMBER: 335530176
VISIT DATE: 03/03/2025
NARRATIVE
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Yards/Outside: Patio, one (1) side gate with self-latching handle on the left side of the house that leads into the backyard, attached two (2) car garage observed. All outdoor pathways were free of obstructions.

Food Service: LPA observed more than two (2) day(s) supply of perishable food and more than seven (7) day(s) supply of non-perishables food and snacks. Dishes, cups, and utensils were stored properly.


Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week.

Records Review: LPA Brown noted that the facility has updated Surety Bond, Liability Insurance and Infection Control Plan. LPA Brown reviewed four (4) client files for admission agreements, medical assessments/physician reports, Individual Program Plan (IPP) and centrally stored medication list/physician orders. LPA Brown observed Client #3 (C3) was admitted to the facility on 12/18/2024 but per documents review, LPA Brown noted that C3 does not have the required medical assessment. Deficiency will be issued. Moreover, LPA Brown observed that Client #2 (C2) has restricted health condition but per documents review, there's no approved restricted health care plan maintained in C2 file. Deficiency will be issued. LPA Brown also reviewed staff and administrator's file for First Aid/CPR, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test result. LPA Brown observed Staff #2 (S2) and Staff #4 (S4) working at the facility with criminal background clearance but their criminal background clearance was not transferred to the facility prior to their employment. Deficiency will be issued and civil penalty of $500.00 per individual and will continue to be assessed of $100.00 per day until corrected.

LPA Brown audited three (3) clients’ medications and no issues were observed. LPA Brown audited three (2) client's P&I and no issue observed.

Deficiencies were cited during this visit. An exit interview was conducted where this report LIC809, LIC809D, LIC421BG and Appeal Rights were discussed, and copies were provided to Licensee/Administrator David DiMauro, Jr..

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2025
LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 03/03/2025 12:57 PM - It Cannot Be Edited


Created By: Melody Brown On 03/03/2025 at 11:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: WE CARE LIVING II
FACILITY NUMBER: 335530176

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
80069(b)
Client Medical Assessments
(b) In ARFs, prior to accepting a client into care, the licensee shall obtain and keep on file documentation of the client's medical assessment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that Client #3 (C3) has Medical Assessment/Physician Report (LIC602) prior to admitting C3 into care on 12/18/2024 which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/04/2025
Plan of Correction
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Licensee stated to submit C3 appointment date to complete the required Medical Assessment/Physican Report (LIC602) to LPA Brown by the Plan of Correction (POC) due date.
Licensee stated to submit Signed Statement of Understanding on CCR 80069(b) to LPA Brown by the POC due date.
Type A
Section Cited
CCR
80092.1(a)
General Requirements for Restricted Health Conditions
(a) A client with a restricted health condition specified in Section 80092 may be admitted or retained in an adult CCF if all requirements in Sections 80092.1(b) through (o) are met.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above by not ensuring that Client #2 (C2) that has Restricted Health Condition has an approved Restricted Health Care Plan maintained in C2 file which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/04/2025
Plan of Correction
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Licensee stated to submit Signed Statement of Understanding on CCR 80092.1(a) to LPA Brown by the POC due date. Licensee stated to submit a copy of C2 Restricted Health Care Plan to LPA Brown once completed.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Efren Malagon
LICENSING EVALUATOR NAME:Melody Brown
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2025


LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 03/03/2025 12:57 PM - It Cannot Be Edited


Created By: Melody Brown On 03/03/2025 at 11:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: WE CARE LIVING II
FACILITY NUMBER: 335530176

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80019(e)(3)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 80019(f) or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above by not ensuring that Staff #2 (S2) and Staff #4 (S4) criminal background clearance were transferred to the facility prior to employment which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2025
Plan of Correction
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Licensee submitted S2 and S4 completed Criminal Background Clearance Transfer Request (LIC9182) with their government issued ID to LPA Brown during the visit today, 03/03/2025. Plan of Correction (POC) cleared.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Efren Malagon
LICENSING EVALUATOR NAME:Melody Brown
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2025


LIC809 (FAS) - (06/04)
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