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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 03:59:30 PM

Document Has Been Signed on 08/08/2023 03:59 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:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Oyejide Oyenpemi, CaregiverTIME COMPLETED:
04:15 PM
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Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Lyday Home 2 Adult Residential Facility to conduct a Case Management Visit in response to an incident report submitted to the Community Care Licensing Office on July 23rd, 2023. LPA met with Caregiver, Oyejide Oyenpemi. LPA introduced self and stated purpose of visit. Inquiry into this incident included conducting a facility tour to assess for any Health and Safety concerns.

The Special Incident Report, (SIR) document noted that on 7/27/23 a resident in care was taken to the hospital while on a visit with family. While out with family, the resident became upset that they could not return home with family. Family transported the resident to the hospital for treatment. When the resident was being prepared for discharge they experienced another breakdown and alleged that staff were mistreating them and expressed that they did not want to return. As of now, the resident is no longer a resident of Lyday Home 2. The resident, belongings and medications have been moved to another facility.

No health and/or safety concerns observed during visit. No deficiencies were cited during this visit. An exit interview was conducted where this report (LIC 809) was reviewed, discussed then provided to facility representative.
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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