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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 335530435
Report Date: 07/01/2026
Date Signed: 07/01/2026 01:24:23 PM

Document Has Been Signed on 07/01/2026 01:24 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:GOLDEN DAYS RCFEFACILITY NUMBER:
335530435
ADMINISTRATOR/
DIRECTOR:
ROBINSON, RHONDAFACILITY TYPE:
740
ADDRESS:1 PONTE LORENTELEPHONE:
(951) 226-7661
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92532
CAPACITY: 6CENSUS: 0DATE:
07/01/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Director/Administrator Rhonda RobinsonTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On July 1, 2026, Licensing Program Analyst (LPA) Andrew Martinez conducted an announced prelicensing visit to the facility and met with Director/Administrator Rhonda Robinson. An initial application to operate a Resident Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 08/01/2025. A fire clearance was granted by the Riverside County Fire Department City of Elsinore on 10/17/2025 approved for a total capacity of six (6); all rooms approved for non-ambulatory residents.

LPA conducted a facility tour with Director/Administrator Robinson where the following was observed:

Physical Plant (Indoor/Outdoor): The facility is a 5 (five) resident bedroom, one (1) staff bedroom, three (3) bathroom home, with a kitchen, dining room, living room, laundry room, open porches, attached three (3) car garage, and staff office area. The facility is clean, sanitary, and in good repair. Indoor and outdoor passageways, open porches and other areas of potential hazard are free of obstructions. One (1) above-ground round spa was observed on property, equipped with a secure, locked cover to keep body of water inaccessible to residents in care. All window screens are clean and in good repair. Indoor facility temperature was a comfortable 73 degrees Fahrenheit. One (1) fireplace was observed on property with a locked screen. The facility is equipped with two (2) fully charged fire extinguishers. The facility is equipped with smoke alarms and carbon monoxide detectors observed to be operating properly. There is adequate amount of seating and space in the indoor common areas for resident activities with furniture in good repair. Outdoor areas are enclosed by a gate with adequate seating and shade for client activities.

Medications: There is a designated locked centralized storage area for client medication.

*** Continued on LIC 809C***

NAME OF LICENSING PROGRAM MANAGER: Karen Clemons
NAME OF LICENSING PROGRAM ANALYST: Andrew Martinez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2026
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: GOLDEN DAYS RCFE
FACILITY NUMBER: 335530435
VISIT DATE: 07/01/2026
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Bedrooms: All resident bedrooms are large enough to allow easy passage and to accommodate furniture and assistive devices. No resident bedrooms are passageways to another room, bath or toilet. Each bedroom is equipped with the required bedding and furniture including clean mattresses, pillows, linen, chairs, dressers, nightstands, and lamps.

Bathrooms: Resident bathrooms are clean and equipped with operating toilets, washbasins, and showers, located near resident bedrooms. Resident bathrooms have adequate supply of toilet paper and hand soap. Hot water temperatures ranged between 113.5 to 116.3 degrees Fahrenheit.

Supplies: There are sufficient amounts of personal hygiene supplies for residents. The facility maintains a sufficient supply of clean linens to permit weekly changing.

Food Service: The dining room is located near the kitchen with tableware and adequate seating. The kitchen and food preparation areas are clean with an adequate number of dishware and utensils for resident use. Food storage areas are large enough for a seven (7) day supply of non-perishable foods, and at least two (2) days of perishable foods. Sample menu is available for review. LPA observed appliances (e.g., stove, refrigerator, freezer) are clean, operating in good condition. Sharps are kept secure in a locked storage area.

Administration: Facility sketch, emergency exiting plan, emergency phone numbers, Resident Personal Rights, Facility's Visitors Policy, Theft and Investigative Policy, Long-Term Care Ombudsman, and Community Care Licensing Complaint Poster are all posted in a common area. There is a confidential storage area for personnel and resident records. Licensee is to obtain and maintain the minimum required liability insurance per regulation prior to licensing, per Health and Safety Code 1569.605.

Miscellaneous: There are fully equipped first aid kits and the facility is in possession of an approved first aid manual. There is space and equipment for laundry, as well as separate spaces for clean linen storage and for soiled linen. The facility's telephone service was verified to be operating properly, and emergency lighting including flashlights and lanterns with extra batteries were observed.

The pre-licensing inspection and Component III orientation are complete with one deficiency noted: Licensee is to obtain and provide proof of liability insurance per regulation prior to obtain licensing. An exit interview was conducted where this Facility Evaluation Report (LIC 809, LIC 809C) was discussed and a copy was provided to Director/Administrator Rhonda Robinson at the conclusion of the visit.

NAME OF LICENSING PROGRAM MANAGER: Karen Clemons
NAME OF LICENSING PROGRAM ANALYST: Andrew Martinez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
LIC809 (FAS) - (06/04)
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