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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336427421
Report Date: 09/26/2024
Date Signed: 09/26/2024 01:51:07 PM

Document Has Been Signed on 09/26/2024 01:51 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:TEMPLE GREENFACILITY NUMBER:
336427421
ADMINISTRATOR/
DIRECTOR:		HOBBS, ESTAFACILITY TYPE:
740
ADDRESS:40086 TEMPLE COURTTELEPHONE:
(951) 249-9234
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY: 6CENSUS: 0DATE:
09/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Licensee, Esta HobbsTIME VISIT/
INSPECTION COMPLETED:
01:55 PM
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Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the for a plan of correction visit. LPA met with Licensee, Esta Hobbs who was informed of the purpose of the visit. LPA conducted walk through of the home and interview with the licensee.

On 9/25/2024, LPA conducted an unannounced visit to the facility in order to conduct a case management. On this date, the licensee was unable to provide access to the home. Health and Safety Code section 1569.33(a) Unannounced Inspections was cited and plan of correction was due by 9/26/2024. LPA conducted an unannounced visit on today’s date 9/26/2024 and was granted entry by the licensee. LPA was able to tour the home and facility grounds. Therefore, the plan of correction has been satisfied.

Licensee was advised on outstanding plan of correction for citation cited on 9/25/2024 for application for change of ownership. The licensee understands civil penalties may apply if the correction is not received by Close of Business, 5:00 p.m.

An exit interview was conducted, where this report and clearance letter was reviewed and provided.

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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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