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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336423880
Report Date: 03/25/2021
Date Signed: 03/25/2021 04:42:20 PM

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:VISTA COVE AT CORONAFACILITY NUMBER:
336423880
ADMINISTRATOR:ALEJANDRA PERDOMOFACILITY TYPE:
740
ADDRESS:2600 SOUTH MAIN STREETTELEPHONE:
(951) 736-4780
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY:49CENSUS: 14DATE:
03/25/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Chiam Raskin, Corona RCFE, LLCTIME COMPLETED:
04:05 PM
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Regional Manager (RM) Leslie Mendiveles, Licensing Program Manager (LPM) Reyna Lacey and Licensing Program Analyst (LPA) Tricia Danielson met with Chaim Raskin of Corona RCFE LLC, who is identified as one of the Licensees of the facility. The purpose of the meeting was to discuss alleged breaches of the tenant's lease agreement and to clarify who is responsible for the operation of the facility.

Mr. Raskin informed Community Care Licensing Division (CCLD) staff that Vista Cove at Corona Inc. is no longer involved in the operations of the facility. Mr. Raskin informed that Corona RCFE LLC is the sole Licensee. Mr. Raskin further explained that there has been no breach in the tenant’s lease agreement. Mr. Raskin indicated the action filed in court has been settled.

CCLD staff requested documentation of the transfer of the license as well as documentation regarding the finalization of the action filed. Mr. Raskin also agreed to provide CCLD with a copy of the agreement between Beechan Health and Corona RCFE LLC, LIC309- Administration Organization, and LIC308- Designation of Facility Responsibility.

A copy of this report was provided to Mr. Raskin via email.

SUPERVISOR'S NAME: Reyna LaceyTELEPHONE: (951) 836-3135
LICENSING EVALUATOR NAME: Tricia DanielsonTELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
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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