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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361881189
Report Date: 12/08/2023
Date Signed: 12/08/2023 02:45:41 PM

Document Has Been Signed on 12/08/2023 02:45 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:SPOELSTRA LLC - VOICE LOMA LINDAFACILITY NUMBER:
361881189
ADMINISTRATOR:THOMAS, ELENAFACILITY TYPE:
775
ADDRESS:24733 REDLANDS BLVDTELEPHONE:
(909) 792-2428
CITY:LOMA LINDASTATE: CAZIP CODE:
92354
CAPACITY: 90CENSUS: 58DATE:
12/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Elena Thomas, Program DirectorTIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Elena Thomas, Program Director, and discussed the purpose of the visit.
The facility is an Adult Day Program and certified vendor for Inland Regional Center (IRC). The facility has a license capacity of 90 with a current census of 58 clients. The facility is operating within ratio. LPA conducted an overall inspection, which included, but was not limited to the following:
The facility passageways are clear and free of obstructions. The facility has (4) areas designated for client activities and recreation. The facility has sufficient lighting and furniture in good repair. The facility is equipped with operating smoke carbon monoxide alarms and telephone service. Posters such as personal rights, facility license, the disaster plan and emergency telephone numbers, were posted in a common area. Cleaning supplies, toxins and other dangerous items were kept locked and stored away from kitchen area. Facility has a designated storage space for client and staff files. Facility has complete first kits and manual. Last fire drill was conducted on 10/31/23.

LPA observed (4) staff files to be complete, and included criminal record clearances and/or exemptions. LPA observed (4) client files to be complete.

Based on observations and record review, no deficiencies were cited during today's visit.

An exit interview was conducted and a copy of this report was provided to the Program Director at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2023
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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