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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336410303
Report Date: 09/20/2023
Date Signed: 09/20/2023 10:27:10 AM


Document Has Been Signed on 09/20/2023 10:27 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:SIMCARE HOMES LLCFACILITY NUMBER:
336410303
ADMINISTRATOR:PERLITA SIMANFACILITY TYPE:
740
ADDRESS:155 BRACEBRIDGE ROADTELEPHONE:
(951) 429-7142
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY:6CENSUS: 4DATE:
09/20/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Perlita & Wilfredo SimanTIME COMPLETED:
08:45 AM
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A virtual office meeting was conducted today in order to gain clarification on the ownership of the facility. Persons present at today’s meeting were: Regional Manager Reyna Lacey, Licensing Program Manager (LPM) Jazmond Harris, Licensing Program Analyst (LPA) Yolanda Delgado, and Licensee’s Wilfredo and Perlita Siman.

Licensees confirmed they were the only managing members of the LLC. Licensee confirmed the property and business was sold to another individual on 05/01/2023. The licensees indicated they informed the residents and their responsible parties with a letter. The licensees were asked to provide a copy of the letters to the Department by 09/26/2023. The licensees were asked if they still had control of property and they indicated they had a lease agreement from the new property owner to the licensee. The lease agreement will be submitted to the Department by 09/22/2023.

Licensees indicated notice to the Regional Office was submitted on 05/02/2023. The licensees confirmed during this meeting, that the new owner is operating the day to day operations as the administrator but they are still the licensee until a new license is issued to the new owner. The licensees indicated they still have oversight and are in charge.

Licensees were advised that another office meeting would be scheduled at a later date, to include the licensees and new owner, to discuss submission of the application.

An exit interview was completed where this report was reviewed and provided by email to the licensees for signature.
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Yolanda DelgadoTELEPHONE: (951) 203-2990
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2023
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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