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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361800450
Report Date: 10/16/2023
Date Signed: 10/16/2023 03:56:31 PM

Document Has Been Signed on 10/16/2023 03:56 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:VALLEY STAR CRT-MORONGO OASIS CENTERFACILITY NUMBER:
361800450
ADMINISTRATOR:HEBESISH, SUZAN ABOUFACILITY TYPE:
772
ADDRESS:60805 29 PALMS HIGHWAYTELEPHONE:
(760) 974-5990
CITY:JOSHUA TREESTATE: CAZIP CODE:
92252
CAPACITY: 16CENSUS: 11DATE:
10/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Suzan Abou-Hebeish, AdministratorTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Magda Malcore made an unannounced required annual visit to the facility. LPA met with Susan Abou-Hebeish, Administrator and discussed the purpose of the visit. The facility is a Social Rehabilitation Facility (SRF). Licensed capacity of (16) and current census of (11) clients. Facility is operating in ratio. LPA conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: LPA observed indoor and outdoor passageways are kept free of obstructions. The facility has sufficient indoor and shaded outdoor space for client activities. The facility has no bodies of water. The facility has a sufficient supply of bed linen, towels and personal hygiene products for clients in care. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; bedrooms were equipped with beds, nightstands, chairs, and storage space. LPA inspected client bathrooms; Bathroom showers are equipment with grab rails and hot water temperatures tested between at 105 degrees F. LPA observed in a common area: Community Care Licensing complaint poster, disaster evacuation plan, and personal rights posters. LPA observed cleaning supplies, toxins, and sharps were kept locked and inaccessible to clients in care.

Food Service: LPA observed a sufficient supply of non-perishable and perishable food for clients in care. Food was stored in a safe and healthful manner. Kitchen hot water temperature tested at 108 degrees F.

Record Review: A facility fire drill was conducted on 10/3/23. LPA reviewed (4) client files for admission agreements, medical assessments, and needs and services plans. LPA also reviewed (4) staff files for criminal record clearance or exemptions, training, and health screenings. LPA observed medications were kept in a locked cabinet inaccessible to clients in care. Medications audited at random were labeled and maintained as prescribed.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: VALLEY STAR CRT-MORONGO OASIS CENTER
FACILITY NUMBER: 361800450
VISIT DATE: 10/16/2023
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No deficiencies were cited during today’s visit. An exit interview was conducted with the Administrator. A copy of this report with appeal rights was provided to the Administrator at the conclusion of the visit.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
LIC809 (FAS) - (06/04)
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