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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360907488
Report Date: 01/23/2025
Date Signed: 01/23/2025 10:30:55 AM

Document Has Been Signed on 01/23/2025 10:30 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:REALM VILLAGE IIFACILITY NUMBER:
360907488
ADMINISTRATOR/
DIRECTOR:		MACALINO, ARLENE E.FACILITY TYPE:
740
ADDRESS:1295 AGATE STREETTELEPHONE:
(909) 794-2800
CITY:MENTONESTATE: CAZIP CODE:
92359
CAPACITY: 10TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/23/2025
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:32 AM
MET WITH:Arlene Macalino AdministratorTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) Bernadette Allen made an announced visit to facilitate the closure of the facility.

(LPA) Bernadette Allen arrived and met with Arlene Macalino, the Administrator. LPA Allen conducted a thorough walk-through of the facility, both indoors and outdoors. LPA confirmed that no residents are residing at the facility. LPA Allen also verified that two residents were placed in other facilities, and one resident moved in with their family.


LPA Allen informed the licensee that the facility is officially closed effective January 23, 2025.


An exit interview was conducted, and a copy of this report was provided to Arlene Macalino at the conclusion of the visit.
Karen ClemonsTELEPHONE: (951) 248-0349
Bernadette AllenTELEPHONE: 951-897-2618
DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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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