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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880520
Report Date: 07/24/2023
Date Signed: 07/24/2023 09:07:18 AM

Document Has Been Signed on 07/24/2023 09:07 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:LYDAY HOME 2 LLCFACILITY NUMBER:
361880520
ADMINISTRATOR:SOLOMON OLOWOFACILITY TYPE:
735
ADDRESS:375 W ROSEWOOD STREETTELEPHONE:
(909) 543-6155
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY: 4CENSUS: 4DATE:
07/24/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
08:38 AM
MET WITH:Chinelo Ogugua- Direct Support Staff 2TIME COMPLETED:
09:15 AM
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Licensing Program Analyst (LPA) Ryan Gardner conducted an announced case management visit to interview a client. LPA met with Direct Support Staff Chinelo Ogugua and explained the reason for the visit.

During today visit, the client was not present to interview. LPA was given contact information to locate the client.

Based on observations today, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.



An exit interview was conducted, and this report was discussed and provided to Direct Support Staff Chinelo Ogugua.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Ryan Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2023
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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