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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880517
Report Date: 03/18/2025
Date Signed: 03/18/2025 03:26:03 PM

Document Has Been Signed on 03/18/2025 03:26 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:ROSE VALLEY REDLANDS IIFACILITY NUMBER:
361880517
ADMINISTRATOR/
DIRECTOR:		MARCOS, MARSIE GAYFACILITY TYPE:
740
ADDRESS:1309 FARVIEW LNTELEPHONE:
(909) 283-4894
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY: 9CENSUS: 7DATE:
03/18/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Administrator Marsie MarcosTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to conduct a Health and Safety check. LPA met with Administrator Marsie Marcos, and discussed the purpose of the visit.

LPA toured the facility. LPA observed a smoke alarm detached from its mount. Although the smoke alarm is detached from its mount, it is functional. The LPA proceeded to test another smoke alarm in facility hallway and facility’s carbon monoxide detector, both of which were found to be in proper working order. LPA observed Administrator and staff attempting to mount smoke alarm back in place, however they were unsuccessful. LPA provided a Technical Violation, Administrator informed LPA a new smoke alarm will be purchased and mounted.

An exit interview was conducted where this report was discussed, and a copy of this safety report along with LIC 9102 was provided to Administrator Marsie Marcos at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Sarina Ramirez
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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