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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880520
Report Date: 08/08/2023
Date Signed: 08/08/2023 03:17:51 PM

Document Has Been Signed on 08/08/2023 03:17 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: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: 2DATE:
08/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Oyejide Oyenpemi, CaregiverTIME COMPLETED:
03:30 PM
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Licensing Program Analyst, Amber Coleman (LPA) arrived at the Lyday Home II Adult Residential Facility unannounced to conduct an Annual Inspection. LPA approached the door and was greeted by staff member, Oyejide Oyenpemi. LPA introduced self and stated the purpose of the visit. Today's visit consisted of a walk through of the facility, staff and resident interviews and review of records.

The facility is a four (4) bedroom, two (2) bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is an Adult Residential Facility (ARF) level 4I residents. The facility is vendorized by Inland Regional Center. Licensed capacity is (4) current census (2). LPA observed the following:

Physical Plant: The facility is operating at 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. LPA inspected resident bedrooms; each room included required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were functional. LPA observed adequate furniture and lighting throughout the facility. The hot water temperature tested within regulation between 102 and 107 degrees. The facility is equipped with operating smoke detectors and carbon monoxide alarms; which were tested during the visit. Posters such as personal rights, Licensing documents, and the disaster plan were posted in the staff area of the kitchen. Cleaning supplies, toxins, sharps, and other dangerous items are kept secure and inaccessible to residents in care. There was a designated storage space for client/staff files. This is near the kitchen in securable file cabinets. Medications are kept inside medications are also kept in a secure file cabinet inaccessible to resident. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care.

Please see LIC9099-C

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
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: LYDAY HOME 2 LLC
FACILITY NUMBER: 361880520
VISIT DATE: 08/08/2023
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Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly.

Based on observations, no deficiencies will be cited per Title 22, California Code of Regulations. A copy of this report was read/reviewed with Facility Representative; signature acknowledges understanding and receipt of report and attachments.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
LIC809 (FAS) - (06/04)
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