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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336425334
Report Date: 03/06/2024
Date Signed: 03/06/2024 11:49:43 AM

Document Has Been Signed on 03/06/2024 11:49 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:COMMUNITY CROSSINGS INC.FACILITY NUMBER:
336425334
ADMINISTRATOR:ANDRADE, AUDREYFACILITY TYPE:
775
ADDRESS:27363 JEFFERSON AVENUE STE. JTELEPHONE:
(951) 296-2158
CITY:TEMECULASTATE: CAZIP CODE:
92590
CAPACITY: 60CENSUS: 50DATE:
03/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator, Audrey AndradeTIME COMPLETED:
12:00 PM
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On 3/6/2024, Licensing Program Analyst (LPA) Janette Romero arrived unannounced to the facility to conduct an annual required inspection. LPA was greeted and granted entry by Program Director (PD), Terry Woodrow who was informed of the purpose of LPA's visit. Administrator, Audrey Andrade arrived during the visit.

During today's visit, there was 50 clients and 19 staff present. LPA conducted a tour with PD Woodrow along with staff and client interviews. The facility has a fire clearance for 60 non-ambulatory clients. The day program is made up of three (3) classrooms, including a media, serenity and art room along with three (3) changing rooms and five (5) bathrooms. The physical plant is in good repair and there were no indoor or outdoor passageway obstructions. LPA observed fire alarm systems and carbon monoxide detectors throughout the facility. The smoke detectors were not tested due to several clients' hypersensitivity. On 2/19/2024, SSD Alarm visited the facility and monitored the alarm system, which was found to be operating as usual. The facility's last emergency disaster drill was conducted on 2/29/2024. LPA observed clients participating in several activities with two (2) groups preparing to go out into the community. There are currently five (5) clients taking medication during day program hours. LPA reviewed the clients' physical medication along with their Medication Administration Record (MAR) and did not discover any discrepancies. The facility has snacks available for clients who do not bring a snack to program. Snacks are stored in a safe and healthful manner. The facility offers several outings and activities throughout the year, which vary. LPA observed photographs of clients touching butterflies, reptiles and sea animals in a fish tank while at the facility. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted where a copy of this report was reviewed and provided to Administrator Andrade.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2024
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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