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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336423880
Report Date: 08/31/2023
Date Signed: 08/31/2023 11:09:54 AM


Document Has Been Signed on 08/31/2023 11:09 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: 12DATE:
08/31/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:56 AM
MET WITH:Administrator Courtney BarretoTIME COMPLETED:
11:15 AM
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 of today's visit.

During a prior visit on 8/22/2023, LPA observed one (1) bedridden resident. Administrator stated R1 received an updated physician report on 8/15/2023 indicating resident is non-ambulatory and no longer bedridden. LPA requested physician notes on why resident was transition from bedridden to non-ambulatory.

During today’s visit, Administrator informed LPA that R1 had received a revised physician report on 8/24/2023 indicating R1 is back to being bedridden. Administrator stated R1 will be relocated. LPA received copies of R1 physican report.

During the facility tour, Administrator stated the seal doors are on pause because facility no longer has a maintenance employee. On the first week of September 2023, facility will be receiving a substitute to assist with their maintenance.

Administrator informed LPA the facility should receive their city approvals the first week of September 2023 to begin their 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 MalagonTELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Mary RicoTELEPHONE: (951) 248-0293
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2023
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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