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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336426054
Report Date: 09/15/2022
Date Signed: 09/15/2022 03:00:22 PM


Document Has Been Signed on 09/15/2022 03:00 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:CALEO BAY ALZHEIMER'S SPECIAL CARE CENTERFACILITY NUMBER:
336426054
ADMINISTRATOR:WILKIN, RONDAFACILITY TYPE:
740
ADDRESS:47805 CALEO BAY DRIVETELEPHONE:
(760) 771-6100
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:66CENSUS: 60DATE:
09/15/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Maria Arruaga - AdministratorTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Crystal Colvin conducted an unannounced visit to the facility for the purpose of a health and safety check. LPA Colvin met with facility Administrator Maria Arruaga, who was informed of the purpose of the visit.

LPA Colvin conducted a tour of the interior and exterior of the facility, and confirmed that the facility has sufficient paper supplies, medications, PPE supplies, staff, and food supplies. No immediate health and safety concerns observed during today's inspection.

An exit interview was conducted where this report was reviewed and provided to Administrator Maria Arruaga.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal ColvinTELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2022
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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