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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361800007
Report Date: 11/06/2024
Date Signed: 11/06/2024 09:52:50 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/06/2024 09:52 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
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:RYAN'S HOME CAREFACILITY NUMBER:
361800007
ADMINISTRATOR/
DIRECTOR:		ROJAS, FRANKLINFACILITY TYPE:
740
ADDRESS:1682 COULSTON STREETTELEPHONE:
(909) 894-4168
CITY:LOMA LINDASTATE: CAZIP CODE:
92354
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
11/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:55 AM
MET WITH:Administrator Maria RodriguezTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Sarina Ramirez and Eldin Serrano arrived unannounced to conduct the required annual visit to the facility. LPAs met with the home owners of the home, Rodrigo and Angelita Lazo and introduced self and stated purpose of the visit. LPAs were informed that the Administrator Maria and Franklin Rodriguez have relocated the residents to a new facility. LPAs conducted a walk through of the home and observed there is no residents in care.
Karen ClemonsTELEPHONE: (951) 836-2784
Sarina RamirezTELEPHONE: (951) 248-0307
DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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