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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 335530339
Report Date: 05/21/2026
Date Signed: 05/21/2026 04:22:39 PM

Document Has Been Signed on 05/21/2026 04:22 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
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:A NEW DAWN HOME CAREFACILITY NUMBER:
335530339
ADMINISTRATOR/
DIRECTOR:		MOJICA, FLORENCEFACILITY TYPE:
740
ADDRESS:1419 NEW DAWN LNTELEPHONE:
(310) 592-5338
CITY:BEAUMONTSTATE: CAZIP CODE:
92223
CAPACITY: 6CENSUS: 0DATE:
05/21/2026
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Administrator, Florence MojicaTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) E. Conchas made an announced visit to the facility to conduct a pre licensing inspection. LPA met with Administrator, Florence Mojica, applicant whom accompanied LPA on the tour. The applicant has applied for a license for an Residential Care for the Elderly Facility. On 01/24/25 the Riverside County Fire Department approved the facility for six (6) non-ambulatory clients. The facility is a single story structure equipped with solar panels, and sprinkler system. The home consists of five (5) bedrooms, three (3) bathrooms, kitchen, laundry room, family room, den, dining, living room area, garage, and backyard with a patio covered seating area. The facility was observed to have the postings such as the personal rights, family council, the facility sketch, meal menu, CCL complaint poster. Personal hygiene supplies and extra linens and towels were observed in closet. Activity items like coloring and puzzle books were also observed to encourage socialization. The facility was observed to have a sufficient food supply. Each client bedroom was observed to have adequate lighting lamp, clean linen, chest of drawers, and chairs. The window screens are in good repair. The bathrooms are equipped with non slip mats and grab bars in the showers however were missing near the toilet area. LPA advised to install the additional grab bars near toilet area. The first aid kit and guide was observed along with manual in PDF format printed. The medications, staff and client files will be stored in a locked cabinet inside the kitchen/dinning area. The chemicals are stored inside a locked cabinet in the laundry room and underneath the kitchen sink. The hot water was tested and found to be within regulatory limits between 112-120 degrees Fahrenheit. There are two (2) fully charged fire extinguishers that were purchased on 02/2026. The smoke and carbon monoxide detectors were tested and found to be operable. LPA advised that the exit pathways be kept clear of all obstructions, including city trash bins, to ensure safe egres out side of room 5. The Composition III presentation was completed during today's visit.

The facility was evaluated in accordance with the California Code of Regulations (CCR), Title 22 Chapter 6, Division 6. Based on the observations and evaluation of the facility this date, the facility’s ready for license.

An exit interview was conducted, and a copy of this report was reviewed and provided to applicant Administrator, Florence Mojica
NAME OF LICENSING PROGRAM MANAGER: Karen Clemons
NAME OF LICENSING PROGRAM ANALYST: Edith Conchas
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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