<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 365530155
Report Date: 11/16/2023
Date Signed: 11/16/2023 11:07:31 AM

Document Has Been Signed on 11/16/2023 11:07 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:BRIAN SCHWICHTENBERG ARF IIFACILITY NUMBER:
365530155
ADMINISTRATOR:SCHWICHTENBERG, BRIANFACILITY TYPE:
735
ADDRESS:16735 CHOCO ROADTELEPHONE:
(951) 295-6430
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY: 2CENSUS: 0DATE:
11/16/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Brian Schwichtenberg
TIME COMPLETED:
11:15 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPA) Mary Rico conducted an announced Pre-Licensing visit to the facility. LPA met with Facility Administrator Brian Schwichtenberg. The pending application is for an Adult Residential Facility. The facility has been granted a fire clearance for a total capacity of two (2) ambulatory on 08/21/2023. The Administrator accompanied LPA on a tour of the inside and outside of the facility. The home is a four (5) bedroom and three (4) bathroom home with a living room, dining room, kitchen, and attached garage. There are no pools, bodies of water, firearms, or ammunition. All bedrooms are furnished with a bed, night stand, and dresser. All bedrooms have adequate lighting for clients use. Bathroom's toilet, shower and tubs are in good repair. LPA observed food storage and preparation areas to be clean and sanitary. Refrigerator and freezer are maintained at appropriate temperatures. All appliances are clean and operating properly. Dishes, glasses, and utensils were in good condition. There is a sufficient supply of linens, towels, and personal hygiene items. The first aid kit was reviewed; all items are present. Medications are stored and locked inaccessible to clients. The facility had a designated area for staff and client records.

During facility tour, LPA did not observe a fence surrounding property that secure safety for future clients. At this time, Pre-licensing inspection will be placed on hold and corrections may be required.

An exit interview was conducted, and a copy of this report was provided to Administrator Brian Schwichtenberg.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
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 1