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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336407734
Report Date: 11/13/2024
Date Signed: 11/13/2024 03:08:07 PM

Document Has Been Signed on 11/13/2024 03:08 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:PICO DE LOROFACILITY NUMBER:
336407734
ADMINISTRATOR/
DIRECTOR:
VIVIEN RILLO/EFREN RILLOFACILITY TYPE:
740
ADDRESS:620 NORTH PERRIS BLVDTELEPHONE:
(951) 943-8081
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 43TOTAL ENROLLED CHILDREN: 0CENSUS: 42DATE:
11/13/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Earlienne Rillo - Administrator Assistant TIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Sara Martinez conducted an announced case management visit to increase the capacity per licensee request. LPA met with Administrator Efren Rillo and Administrator Assistant Earlienne Rillo and explained the purpose of the visit. At the time of visit there were 42 residents.

Licensee requested a capacity increase from forty-three (43) residents to forty-five (45) residents. A Fire Clearance was approved on 09/10/2024 for two (2) additional non-ambulatory residents, of which of the 2 may also be bedridden. Facility sketch on file shows sufficient square footage in the facility and activity rooms to accommodate the requested capacity. LPA Martinez discussed the facility sketch with Licensee which provided amble space for 45 residents. LPA Martinez toured the interior/exterior of the building and visually inspected the resident bedrooms. LPA Martinez confirmed that all identified shared rooms are large enough to accommodate the required furniture for two residents without inhibiting movement into and throughout the rooms. The facility has 23 bedrooms for the residents with 21 bedrooms containing an attached bathroom. The facility has 4 additional bathrooms located throughout the facility. LPA Martinez additionally confirmed that there are sufficient bathrooms in the facility to meet Title 22 requirements for ratio of residents to bathrooms.

The physical plant is ready for increase in capacity. LPA will submit file for capacity increase approval. The final approval of capacity increase is contingent upon LPM's final file review. Licensee will be notified by LPA once capacity increase has been approved by licensing. If capacity increase is approved, new license will follow in the mail after phone notification by LPA with Licensee.

An exit interview was conducted where this report was discussed with and a copy was provided to Rillo.

Tricia DanielsonTELEPHONE: (951) 202-5067
Sara MartinezTELEPHONE: (951) 605-0913
DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
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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