<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336425347
Report Date: 01/24/2025
Date Signed: 01/24/2025 03:22:28 PM

Document Has Been Signed on 01/24/2025 03:22 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:KAISER ADULT BEHAVIORAL CENTER TEMECULAFACILITY NUMBER:
336425347
ADMINISTRATOR/
DIRECTOR:
SOUZA, SHARIFACILITY TYPE:
775
ADDRESS:27496 COMMERCE CENTER DR STE HTELEPHONE:
(951) 225-2632
CITY:TEMECULASTATE: CAZIP CODE:
92590
CAPACITY: 60CENSUS: 19DATE:
01/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Administrator, Cherise DwyerTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 1/24/2025, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator, Cherise Dwyer who was informed of the purpose of the visit. The facility is a licensed vendor of the Inland Regional Center. During the visit, there was 19 clients and eleven (11) staff present.

LPA toured the facility with Supervisor, Michelle Penaloza. The facility is made up of eight (8) classrooms, five (5) bathrooms, two (2) staff offices, a dining room, and multipurpose room. LPA toured the kitchen and observed the kitchen area to be clean. Restrooms were clean and had toilet paper, paper towels, and soap readily available for the clients. Cleaning solutions and disinfectants were secured in a storage closets, inaccessible to clients. The facility does not provide any medication assistance. LPA reviewed random staff and resident files. Staff present have a criminal record clearance. Client files had physician's reports and Individual Program Plans. The facility’s last fire drill was conducted on 1/20/2025. The smoke alarms/carbon monoxide detectors were not tested due to some clients' audio sensitivity. LPA reviewed a Job Work Order dated 10/21/2024, which documented Champion Fire Systems Incorporated tested and inspected the facility's fire alarms and no defects were found. LPA observed charged fire extinguishers mounted throughout the facility last serviced on 6/25/2024. During today’s visit, LPA did not observe any issues or concerns. An exit interview was conducted and this report was reviewed and provided to Administrator Dwyer.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1