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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 335530268
Report Date: 02/07/2025
Date Signed: 02/07/2025 02:57:18 PM

Document Has Been Signed on 02/07/2025 02:57 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:SALVATION RESIDENTIAL CAREFACILITY NUMBER:
335530268
ADMINISTRATOR/
DIRECTOR:		CAGE, WANDAFACILITY TYPE:
735
ADDRESS:22776 SALVATION WAYTELEPHONE:
(323) 535-8303
CITY:WILDOMARSTATE: CAZIP CODE:
92595
CAPACITY: 6CENSUS: 0DATE:
02/07/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:18 PM
MET WITH:Applicant Philiet Spane and Administrator/Applicant Wanda CageTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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On 02/07/2025 at 02:18 PM, Licensing Program Analyst (LPA) Melody Brown conducted an announced pre licensing visit. This is an announced Pre-Licensing visit conducted with Applicant Philiet Spane and Administrator/Applicant Wanda Cage who assisted in the tour of inside and outside of facility and the evaluation. LPA Melody Brown made a second (2nd) announced prelicensing visit this date. The follow up visit was made to confirm that all corrections have been made.

The following: “(1) Obtain First Aid Book (2) Obtain and post Community Care Licensing Division (CCLD) Let-Us-Know poster (3) Develop Menu (4) Post Activity Calendar (5) Post Facility Sketch on common areas (6) Print and Post House Rules (7) Print and Post Visitor Policy (8) Clients & Visitors Sign-in & Sign-out Sheet”

All were found to be corrected on this visit date, 02/07/2025.

The facility was evaluated in accordance with the California Code of Regulation (CCR), Title 22, Division 6, Chapter 6 to ensure the health and safety of clients in care. Based on the observations and evaluation of the facility this date, the facility’s ready for licensure.

Applicants will be notified once facility is licensed.

An exit interview was conducted, and a copy of this report was left with Applicant Philiet Spane and Administrator/Applicant Wanda Cage.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2025
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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