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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336405886
Report Date: 01/10/2025
Date Signed: 01/10/2025 12:27:14 PM

Document Has Been Signed on 01/10/2025 12:27 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:INTEGRATED CARE COMMUNITIES - B2FACILITY NUMBER:
336405886
ADMINISTRATOR/
DIRECTOR:
EMELY C. RODRIGUEZFACILITY TYPE:
740
ADDRESS:14315 NASON STREETTELEPHONE:
(951) 601-9170
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92555
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 13DATE:
01/10/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH:Emely RodriguezTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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On January 10, 2025, Licensing Program Analysts (LPAs), Abdoulaye Zerbo and Seo Jeon did an unannounced visit to conduct a case management, and met with the Administrator Emely Rodriguez. LPAs introduced themselves and stated the purpose of the visit.

LPAs toured the facility, along with the Administrator Emely Rodriguez, conducted interviews and made observations. The facility have three(3) staff per shift attending the residents' needs and conducting rounds every hour or more frequently if needed. There were no imminent health and/or safety concerns observed at the time of visit.

LPAs did not observe any obstructions or debris inside or outside of the facility at the time of this visit. LPAs observed that the facility is using a generator as a source of power due to the outage. LPAs assessed the available food and observed sufficient food to be available for the residents in care. The food supply meets the requirement of a two-day supply of perishable foods and a seven-day supply of non-perishable foods. . The medications were found to be in sufficient supply, locked, and inaccessible to the residents in care. The facility is clean, and meets all the requirements for the residents in care.

Based on the information obtained during today's visit, there were no immediate health and safety issues of the residents in care.

An exit interview was conducted, and a copy of this report was provided to the Administrator, Emely Rodriguez.

Rikesha StampsTELEPHONE: (951) 212-0616
Abdoulaye ZerboTELEPHONE: (951) 248-2222
DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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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