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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 365530155
Report Date: 01/12/2024
Date Signed: 01/12/2024 01:04:18 PM

Document Has Been Signed on 01/12/2024 01:04 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: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:
01/12/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator Brian SchwichtenbergTIME COMPLETED:
10:47 AM
NARRATIVE
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Licensing Program Analyst (LPA) Mary Rico conducted an announced Second Pre-Licensing visit to the facility. LPA met with Facility Administrator Brian Schwichtenberg. A follow-up visit was conducted to confirm the corrections were made.

LPA Rico observed the facility had a fence securing the facility for future clients. Facility passed their Pre-licensing inspection.

An exit interview was conducted, and a copy of this report (LIC809) was discussed and provided to Administrator Brian Schwichtenberg

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2024
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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