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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336409394
Report Date: 12/27/2024
Date Signed: 12/27/2024 09:57:11 AM

Document Has Been Signed on 12/27/2024 09:57 AM - 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:JONES ADULT CARE FACILITY IFACILITY NUMBER:
336409394
ADMINISTRATOR/
DIRECTOR:		DEBORAH L. COLLINSFACILITY TYPE:
735
ADDRESS:24211 FINLEY AVENUETELEPHONE:
(951) 247-1577
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 6CENSUS: 3DATE:
12/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Licensee, Deborah CollinsTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 12/27/2024, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to conduct a required annual inspection. LPA was greeted and granted entry by Licensee, Deborah Collins who was informed of the purpose of the visit.

LPA toured the facility with Staff, Sheila Evans and was informed clients were attending day program. During the tour, LPA observed the facility is made up of a one (1) story home with four (4) bedrooms, two (2) bathrooms two (2) living rooms, a kitchen, dining room, and an attached garage. Indoor and outdoor passageways are free of obstruction. Outdoor shaded seating is available for clients in care. The facility has an outdoor in-ground gated pool that is secured with a master lock. Staff Evans tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed charged fire extinguishers mounted in the facility that were last serviced on 10/25/2024. LPA toured the kitchen and observed the facility has a two-day supply of perishable foods and seven-day supply of non-perishable foods. The facility's living room fire place is adequately screened. Cleaning solutions and disinfectants are secured in a locked cabinet in the garage. The facility has hallway closet filled with clean towels and hygiene supplies for the clients in care. LPA reviewed random staff and client files. Client files reviewed had updated Individual Program Plans and signed admission agreements. Staff present has a criminal record clearance. The facility's last fire drill was conducted on 11/3/2024. The facility safeguards the clients' cash resources. LPA reviewed the Record of Client's Safeguarded Resources for all three (3) clients while Staff Evans counted their physical monies.

During today's visit, LPA did not issue any citations. An exit interview was conducted and a copy of this report was reviewed and provided to Licensee Collins.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2024
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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