361800189-7-9-2026-56-AS-ESEO-DVTRS2-20260709131602

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 361800189
Report Date: 07/09/2026
Date Signed: 07/09/2026 01:16:18 PM

Document Has Been Signed on 07/09/2026 01:16 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 ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	VALLEY STAR CRISIS RES. TREATMENT- DESERT HILL		FACILITY NUMBER:	361800189
ADMINISTRATOR/ DIRECTOR:	SYLVIA RODRIGUEZ		FACILITY TYPE:	772
ADDRESS:	16552 SUNHILL DRIVE		TELEPHONE:	(760) 780-4400
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92395
CAPACITY: 16		CENSUS: 16	DATE:	07/09/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:55 AM
MET WITH:	Jasmine Garibay Quality Assurance		TIME VISIT/ INSPECTION COMPLETED:	01:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPAs) Eldin Serrano and Matthew Aguilar arrived unannounced to conduct the required annual visit to the facility. LPAs met with Quality Assurance Jasmine Garibay and introduced self and stated the purpose of the visit. LPAs were informed that there are currently 16 clients in care in the facility. The facility has 11 client bedrooms, 6 bathrooms, offices plus staff bathrooms, kitchen, pantry, dining area, quiet room, nurses room with offices, medication room, client storage room, interview room, security room, web area, emergency supply room, family room, entertainment room, laundry room, linen room, electrical storage room and shaded patio. LPAs completed a walk through of facility, review of records, and medication audit. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 75.7 degrees Fahrenheit. LPAs inspected client bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting. LPAs inspected client bathrooms; bathrooms appliances were found functional. Water temperatures tested at 117.1 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms and seven (7) charged fire extinguishers. Posters such as; the personal rights, visitors rules, and CCL complaint poster were posted in a common area. Cleaning supplies, toxins, sharps and other dangerous items were kept secure locked and inaccessible to clients. Clients/staff files are kept locked inside the office. Medications and first aid kits were observed locked and inaccessible to clients. LPAs observed plenty of towels, linens and comforters in the linen room. There are no firearms, ammunition, swimming pool or bodies of water in the facility. Overall, the facility is in good repair, and operating in safe conditions for clients in care. LPA observed the the facility do not have an updated emergency drill. Deficiency issued. * Continuation in LIC809C *

NAME OF LICENSING PROGRAM MANAGER: Karen Clemons
NAME OF LICENSING PROGRAM ANALYST: Eldin Serrano
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: VALLEY STAR CRISIS RES. TREATMENT- DESERT HILL	FACILITY NUMBER: 361800189
	VISIT DATE: 07/09/2026

NARRATIVE

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Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a wide variety of food available. Dishes, cups, and utensils were also stored properly. Emergency food and water were also observed.

Yards/Outside: One shaded patio, two (2) side gates with self-latching handle on the right side and back side of the facility that leads into the parking lot. All outdoor pathways were free of obstructions.

Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week.

Record Review: LPA reviewed four (4) client files for admission agreements, medical assessments/physician reports, and Individual Services Plan. LPA observed files reviewed were complete. LPA also reviewed four (4) staff file for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test result and observed files were complete.

LPA audited four (4) clients’ medications and no issues were observed.

One deficiency was cited during this visit per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report LIC809, LIC809C, LIC809D and LIC9102 were discussed, and copies were provided to Quality Assurance Jasmine Garibay.

NAME OF LICENSING PROGRAM MANAGER: Karen Clemons
NAME OF LICENSING PROGRAM ANALYST: Eldin Serrano
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/09/2026 01:16 PM - It Cannot Be Edited

Created By: Eldin Serrano On 07/09/2026 at 12:59 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: VALLEY STAR CRISIS RES. TREATMENT- DESERT HILL	FACILITY NUMBER: 361800189
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1565(c)

Other Provisions

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of individuals served by the facility is not required during a drill. While a facility may provide an opportunity for individuals served by the facility to participate in a drill, it shall not require that participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and, if applicable, the names of staff participating in the drill. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, record review, the licensee did not comply with the section cited above by not ensuring that the facility has an updated emergency drill that was supposed to be done every quarter, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/16/2026
	Plan of Correction
1 2 3 4	Licensee will submit the conducted emergency disaster drill signed by all employees who attended the drill on plan of correction (POC) due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Karen Clemons
NAME OF LICENSING PROGRAM MANAGER:

	Eldin Serrano
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/09/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026

LIC809 (FAS) - (06/04)

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