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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336407851
Report Date: 05/04/2021
Date Signed: 05/25/2021 02:55:34 PM

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:SENIOR FOCUS RESIDENTAL CARE #3FACILITY NUMBER:
336407851
ADMINISTRATOR:MARGARET LAMARFACILITY TYPE:
740
ADDRESS:871 VIA MINDITELEPHONE:
(951) 684-2511
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY:6CENSUS: 0DATE:
05/04/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Margaret Lamar, LicenseeTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Amy Goldenberg conducted a virtual case management visit on this date with Licensee Margaret Lamar. LPA virtually toured the facility via facetime to verify that all residents have been moved from the facility. LPA verified that the facility has closed and is no longer retaining any residents. LPA advised Margaret Lamar to mail in the facility license.
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 248-0339
LICENSING EVALUATOR NAME: Amy GoldenbergTELEPHONE: (951) 248-0351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2021
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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