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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336412413
Report Date: 07/07/2022
Date Signed: 07/19/2022 10:22:41 AM

Document Has Been Signed on 07/19/2022 10:22 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:LOVE AND COMFORT HOME CARE (LLC)FACILITY NUMBER:
336412413
ADMINISTRATOR:MILAGROS WILSONFACILITY TYPE:
740
ADDRESS:69440 MEGAN CT.TELEPHONE:
(760) 992-8893
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY: 6CENSUS: 0DATE:
07/07/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:45 AM
MET WITH:Milagros Flores, LicenseeTIME COMPLETED:
01:15 AM
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Licensing Program Analyst (LPA) Jesse Gardner made an announced visit for the purpose of the facility's closure. LPA was met by Licensee Milagros Flores. Licensee contacted LPA in reference to the closure of the facility. Licensee informed LPA that there were no residents living in the facility. The Licensee is initiating this closure. The effective date of closure is 7/7/22. LPA inspected the facility which included the bedrooms, bathrooms, dining area, kitchen, backyard and garage.

LPA confirmed there were no residents present, and there are no personal belongings for any resident. Licensee stated the reason for closure was lack of caregiver support, and Licensee's health. Licensee submitted the single resident that was left at the facility at time of closure's responsibility party information.

Licensee also produced their original license. An exit interview was conducted where a copy of this report was discussed with and provided to Licensee.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
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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