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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361800015
Report Date: 09/13/2023
Date Signed: 09/13/2023 02:51:31 PM


Document Has Been Signed on 09/13/2023 02:51 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:MOUNTAIN VIEW COTTAGES VIIFACILITY NUMBER:
361800015
ADMINISTRATOR:JASBINDAR SINGHFACILITY TYPE:
740
ADDRESS:917 EAST MESA DRIVETELEPHONE:
(909) 566-4000
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:6CENSUS: 5DATE:
09/13/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Myra Guaratato, CaregiverTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Mountain View Cottages VII unannounced to conduct a case management visit. This case management visit is being made to confirm that the plan corrections has been carried out. LPA rang the door bell. LPA greeted and granted entry by Caregiver, Myra Guaratato. LPA introduced self and stated purpose of the visit. LPA signed in and completed a walk through of the facility. There were 5 residents present during the visit.

At approximately, 1:50pm LPA completed a walk through of the facility's backyard. LPA observed three, (3) stray cats outside of the door. These cats appeared small. 1. Orange and White. 2. Black and Brown, 3 all Brown. On the left side of the patio, LPA observed a bucket of water, seemingly left for the cats to partake. Staff interviews revealed that is a resident's behavior to continue putting water outside for the cats. According the Administrator, animal control has been contacted to assist with having the cats removed from the property.

At approximately 1:55pm LPA observed the unattached storage building. The roof appeared to be fixed. Staff showed LPA the inside of the structure. LPA observed that the structure is secure and used for extra storage space. LPA observed the rest of the outside of facility, the roof was addressed for both the facility and the unattached garage.

Based on observations and interviews, no deficiencies are being cited. An exit interview was conducted where this report was reviewed, discussed then provided the facility representative.

SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Amber ColemanTELEPHONE: 951-248-0338
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2023
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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