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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360911233
Report Date: 02/28/2024
Date Signed: 02/28/2024 09:21:44 AM


Document Has Been Signed on 02/28/2024 09:21 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:LA POSADA IIFACILITY NUMBER:
360911233
ADMINISTRATOR:HERNANDEZ, ORFA RUTHFACILITY TYPE:
740
ADDRESS:3875 NORTH BELLE STREETTELEPHONE:
(909) 881-1344
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:11CENSUS: 6DATE:
02/28/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Ruth Chernovsky, LicenseeTIME COMPLETED:
09:23 AM
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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced Proof of Correction (POC) visit for a deficiency cited during the facility's last annual inspection conducted on 12/12/2023.

During today's visit, LPA reviewed facility records and conducted a staff interview.
  • Deficiency 1569.618(c)(3) has been cleared. Licensee complied with the terms of the POC as LPA reviewed completed required CPR/First Aid training completed on/or before 01/04/2024.

Letter of Cleared POC were issued during today's visit. This report was reviewed with and a copy was provided to Mrs. Chernovsky.
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2024
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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