336423880-8-22-2023-56-AS-MRIO-CUXUMP-20230822154240

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336423880
Report Date: 08/22/2023
Date Signed: 08/22/2023 03:42:46 PM

Document Has Been Signed on 08/22/2023 03:42 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	VISTA COVE AT CORONA		FACILITY NUMBER:	336423880
ADMINISTRATOR:	COURTNEY BARRETO		FACILITY TYPE:	740
ADDRESS:	2600 SOUTH MAIN STREET		TELEPHONE:	(951) 736-4780
CITY:	CORONA	STATE: CA	ZIP CODE:	92882
CAPACITY:	49	CENSUS: 12	DATE:	08/22/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:48 PM
MET WITH:	Administrator Courtney Barreto		TIME COMPLETED:	03:48 PM

NARRATIVE

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Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to conduct a Case Management visit regarding facility fire clearance. LPA Rico met with Administrator Courtney Barreto and explained the reason for the visit.

During a prior visit on 7/28/2023 LPA discovered the facility did not relocated the three (3) bedridden residents. During today’s visit, LPA observed one (1) bedridden resident. Administrator stated that resident received an updated physician report on 8/15/2023 indicating resident is non-ambulatory and no longer bedridden. Administrator informed LPA facility is waiting for physician notes on why resident was transition from bedridden to non-ambulatory. Additional information will be provided to LPA.

During the facility tour, LPA Rico observed the following items: three feet clearance from electrical panel, toxins located in their own storage inaccessible to clients in care, no open ceilings, stove removed from room 14, removed gas appliances, and no heating supplies.

LPA reviewed facility fire watch log, facility began their fire watch on 7/14/2023 and have continue to document.

Administrator informed LPA the facility is working on repairing the seal doors, and for their fire alarm system the facility received a quotation from “Troy Alarm, INC ” on 7/5/2023 but have not begun their installation. Administrator stated they are waiting for the city approval. At this time, Administrator did not provide a start date.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Mary Rico	TELEPHONE: (951) 248-0293
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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 CORONA	FACILITY NUMBER: 336423880
	VISIT DATE: 08/22/2023

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LPA received copies of resident physician report, and quotation of fire alarm.

Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report was discussed and provided to Administrator Courtney Barreto

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Mary Rico	TELEPHONE: (951) 248-0293
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

LIC809 (FAS) - (06/04)

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