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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336426777
Report Date: 08/23/2023
Date Signed: 08/23/2023 11:58:46 AM

Document Has Been Signed on 08/23/2023 11:58 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 AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:IN-ROADS DAY PROGRAM #3FACILITY NUMBER:
336426777
ADMINISTRATOR:ANGELICA HILL-GARCIAFACILITY TYPE:
775
ADDRESS:26900, 04, 08 CHERRY HILLS BLVTELEPHONE:
(951) 672-1800
CITY:MENIFEESTATE: CAZIP CODE:
92586
CAPACITY: 45CENSUS: DATE:
08/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Angelica Hill, DirectorTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Jacqueline Shaw Ross conducted an unannounced visit to the facility for the purpose of an annual inspection. LPA was greeted and granted entry by Administrator, Tammy Enos. Director, Angelica Hill arrived shortly. A tour of the facility was conducted inside and out.

The facility has no bodies of water or firearms. Outdoor and indoor passageways were kept free of obstruction. The facility currently does not dispense medications. LPA observed safe and healthy indoor activity space for the clients. LPA also observed designated areas where activities such as exercise, dancing, arts and learning activities take place. LPA observed several complete first aid kits throughout the facility and the last disaster drill conducted was on 7/24/2023. The facility has charged seven (7) fire extinguishers. Fire alarms and carbon monoxide detectors were tested and found operable. Appropriate signage was posted throughout the facility. Indoor temperature measured 70 degrees F.

LPA toured the kitchen areas. The facility provides snacks for the clients. LPAs observed that snacks are stored in a safe and healthful manner. Cleaning supplies and sharps were kept locked and inaccessible to the clients. LPA toured the client bathrooms. Bathrooms were maintained in safe and sanitary conditions. LPA measured the hot water temperature in the bathroom. The hot water temperature measured 111.4 degrees F.

Staff and client interviews were conducted. LPA reviewed staff and client files.
Staff files had the required documentation including a health screening report and current first aid/CPR certification. Client files had the required documentation including an admission's agreement and updated IPP's.

During today's visit, LPA did not observe any deficiencies. A copy of this report was discussed and provided to Director, Angelica Hill.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Jacqueline Shaw Ross
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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