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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336402166
Report Date: 02/13/2024
Date Signed: 02/13/2024 02:02:36 PM


Document Has Been Signed on 02/13/2024 02:02 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
RIVERSIDE, CA 92507



FACILITY NAME:JMP CARE HOMEFACILITY NUMBER:
336402166
ADMINISTRATOR:EMELITA M. PRICEFACILITY TYPE:
740
ADDRESS:2771 CAMBRIDGE AVENUETELEPHONE:
(951) 282-2819
CITY:HEMETSTATE: CAZIP CODE:
92545
CAPACITY:6CENSUS: 2DATE:
02/13/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:43 AM
MET WITH:ADMINISTRATOR, EMELITA PRICETIME COMPLETED:
02:08 PM
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On February 13, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived to the Facility unannounced to conduct the required annual inspection and met with Emelita Price, the Administrator and introduced herself. The LPA stated the purpose of the visit. The File review was conducted in the office and additional forms were requested and reviewed at the facility.

LPA Mixson toured the facility, along with Emelita, and inspected the inside and outside of the facility. The facility is a single story building located at 2771 CAMBRIDGE AVENUE Hemet, CA. 92545. The facility phone number is (951) 282-2819 and it is operable.
Physical Plant: The physical plant, is in good condition, neat, and orderly. Outdoor and indoor passageways are free of obstruction at the time of this visit. The facility rooms have the required furniture; such as tables, chairs, storage space, and sufficient lighting. The building temperatures throughout was per regulations. The bedrooms are equipped with the required items, per Title 22. The hot water temperature was tested, and within the range required for regulations. The restrooms were equipped with liquid soap and paper towels. LPA Mixson toured the kitchen it was clean and free of orders. The facility has emergency food and water. LPA Mixson inspected the common areas. The fire extinguisher was in the green and the facility takes the extinguisher for service. Carbon monoxide alarms, along with smoke detectors were observed. There was a locked and centralized storage area for medications. Medications are contained in bubble packs, and supplied by the Medicine Shoppee Pharmacy. The facility had a designated area for resident and staff files, and it was locked. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There was adequate seating in the common areas and sufficient space for activities. LPA Mixson reviewed staff and resident files, and conducted staff interviews and no resident interview due to the resident being at the Day Program. There were no regulation violations observed during todays visit. An exit interview was conducted and a copy of this report was provided to the Administrator, Emelita Price .
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus MixsonTELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2024
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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