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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336423880
Report Date: 07/28/2023
Date Signed: 07/28/2023 11:45:18 AM


Document Has Been Signed on 07/28/2023 11:45 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:VISTA COVE AT CORONAFACILITY NUMBER:
336423880
ADMINISTRATOR:COURTNEY BARRETOFACILITY TYPE:
740
ADDRESS:2600 SOUTH MAIN STREETTELEPHONE:
(951) 736-4780
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY:49CENSUS: 16DATE:
07/28/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:06 AM
MET WITH:Administrator Courtney BarretoTIME COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) Mary Rico arrived at the facility to conduct an unannounced case management visit. LPA met with Administrator Courtney Barreto a explained the reason for the visit. LPA was accompanied by Facility Administrator Courtney Barreto to conduct a facility tour.

During a prior visit on 7/20/2023, LPA Rico discovered the facility is providing care for four (4) bedridden residents which is not approved per the facilities license. During this visit, the facility was given a deficiency and a plan of correction to relocate four (4) bedridden residents.

During today’s visit, LPA discovered the facility has not relocated the three (3) bedridden residents. By continuing to provide care for the three (3) bedridden residents it poses an immediate health, safety, or personal rights risk to persons in care.

Based on observations today, a civil penalty in the amount of $800 dollars will be issued for failure to correct the violation within a specified length of time that result in a civil penalty. The facility will be issued one (1) civil penalty per Title 22, Division 6, of the California Code of Regulations,

An exit interview was conducted, and this report (LIC809) was discussed and provided to, Administrator Courtney Barreto along with a copy of LIC42FC, and the appeal rights.

SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Mary RicoTELEPHONE: (951) 248-0293
LICENSING EVALUATOR SIGNATURE:
DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/28/2023
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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