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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361881137
Report Date: 07/31/2023
Date Signed: 07/31/2023 01:36:28 PM

Document Has Been Signed on 07/31/2023 01:36 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:RADIANTLIZ HOMECAREFACILITY NUMBER:
361881137
ADMINISTRATOR:CALLEJAS, FLORDELIZA P.FACILITY TYPE:
735
ADDRESS:9730 CUPID WAYTELEPHONE:
(909) 771-3880
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY: 2CENSUS: 0DATE:
07/31/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Floradeliza Callejas, AdministratorTIME COMPLETED:
01:45 PM
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Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Radiantliz Homecare Facility unannounced to conduct an Annual Inspection. LPA knocked on the door and was greeted by Administrator Floradeliza Callejas. LPA introduced self and stated the purpose of the visit, Admin. grated LPA entry to facility. Administrator informed LPA that there are no residents residing in the home at this time. The facility os still pending vendorization of the Inland Regional Center. Administrator provided LPA with space to work as well as a tour of the facility.

The facility consists of four (4) bedrooms, two (2) bathrooms kitchen/dining area, living room, and attached garage. The facility is an Adult Residential Facility (ARF) approved for 2 ambulatory adults.

Physical Plant: The facility is operational and ready to admit residents 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 the designated resident bedrooms; which included required furniture such as: mattresses, night stands, storage space, and sufficient lighting. Bathrooms were clean, and appliances were functional. LPA observed sufficient furniture for seating and lighting throughout the facility. The hot water temperature tested within regulated range. The facility is equipped with operational smoke detectors and carbon monoxide alarms. Posters such as personal rights, infection control, and the CCL complaint poster, and the disaster plan were posted in common areas. Cleaning supplies, toxins, sharps, and other dangerous items were kept in secure locations within the kitchen, garage and hallways. There was a designated storage space for client/staff files. Medications are kept inside medication securable cabinet inaccessible to residents. Additional linens were observed in the hallway closet. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: RADIANTLIZ HOMECARE
FACILITY NUMBER: 361881137
VISIT DATE: 07/31/2023
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Food Service: Non-perishable and perishable food supply is sufficient for potential residents in care. Facility offers a variety of food to potential residents. Dishes, cups, and utensils were also stored properly.

A technical violation is being issued to address the facility's fire extinguishers with expired inspection dates. No deficiencies will be cited per Title 22, California Code of Regulations. An exit interview was conducted. A copy of this report was read/reviewed with Administrator. Signature acknowledges understanding and receipt of report and attachments.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023
LIC809 (FAS) - (06/04)
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