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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336409389
Report Date: 05/24/2022
Date Signed: 05/24/2022 03:46:40 PM


Document Has Been Signed on 05/24/2022 03:46 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:SILVER HILLS HOME CAREFACILITY NUMBER:
336409389
ADMINISTRATOR:MADALINA ROTARFACILITY TYPE:
740
ADDRESS:7891 SILVER HILLS DRTELEPHONE:
(951) 789-4667
CITY:RIVERSIDE,STATE: CAZIP CODE:
92506
CAPACITY:2CENSUS: 0DATE:
05/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Magdalina Rotar, LicenseeTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA), Stephanie Torres, made an unannounced visit to the facility in order to conduct the annual inspection, with an emphasis on infection control. The LPA met with Licensee, Magdalina Rotar, and informed her of the purpose of her visit. There are currently no residents in care at this time.

The LPA toured the facility and observed no health and safety concerns. No COVID-19 measures were observed in place at time of visit. The Licensee agreed to review the Department's COVID-19 guidelines and put in place infection control measures prior to accepting any residents into care.

This report was reviewed with Rotar and a copy provided.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2022
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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