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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 365530354
Report Date: 05/15/2026
Date Signed: 05/15/2026 01:17:43 PM

Document Has Been Signed on 05/15/2026 01:17 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 ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:SULE'S LOVING HOMEFACILITY NUMBER:
365530354
ADMINISTRATOR/
DIRECTOR:		PARRA, SULEMA E.FACILITY TYPE:
735
ADDRESS:5121 SAMMY HAGAR WAYTELEPHONE:
(909) 329-9740
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY: 4CENSUS: 2DATE:
05/15/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Licensee/Administrator Sulema E ParraTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 05/15/2026, Licensing Program Analyst (LPA) Beena Singh conducted an announced visit to the facility to conduct a required annual visit. LPA Singh met with Licensee/Administrator Sulema E Parra. The facility is an Adult Residential Facility (ARF), level 4i. The facility is an Inland Regional Center (IRC) certified vendor with a license capacity of (4) and a current census of (2). There are two(2) clients at the facility and were out in the community. Licensee/Administrator Sulema E Parra informed of the purpose of the visit and was granted entry to the facility. LPA Singh observed the following:

Facility is a two (2) story house with five (5) bedrooms, one staff and four(4) client bedrooms, three (3) bathrooms, living room, dining room, and kitchen. There was an attached Three(3) car garage on the left side of the house. Central heating and air conditioning system installed with one (1) central panel located in the hallway to control entire house.

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. Outdoor activity space is shaded and enclosed with a self-latching left side gate. The facility is maintained at a comfortable temperature of 71 degrees Fahrenheit. Client bedrooms were equipped with mattresses, night stands, storage space, and lighting. Client bathrooms were clean, and appliances were operating appropriately. The facility is equipped with smoke detectors and carbon monoxide alarms, two (2) fully charged fire extinguishers, first aid kit w/manual, telephone service, emergency supplies and water. The facility has been posted in a common area: client personal rights, the CCLD complaint poster, emergency telephone numbers, activities calendar, menu and facility license.

NAME OF LICENSING PROGRAM MANAGER: Efren Malagon
NAME OF LICENSING PROGRAM ANALYST: Beena Singh
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SULE'S LOVING HOME
FACILITY NUMBER: 365530354
VISIT DATE: 05/15/2026
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Each client bedrooms accommodate any ambulatory client. All client bedrooms were adequately furnished with bed, chair, closet, appropriate linen, adequate lighting, a lamp and an operable smoke/carbon monoxide alarm. The three (3) bathrooms have a working toilet, wash basin, and shower with an adequate supply of toilet paper and soap. LPA tested the water temperatures in the clients' bathroom. LPA Singh verified water temperature was 110 degrees Fahrenheit.

Food Service: The facility has more than seven (7) days’ supply of Non-perishable foods and more than two (2) days’ supply of perishable food for clients in care.

An adequate supply of dishes, glasses, utensils, pots, and pans were observed. Knives/sharp instruments were secured in a locked cabinet located in the dining room. There was adequate room for food storage. LPA Singh observed the stove to be operational. Refrigerator/freezer were in working condition. There is sufficient storage for perishable food. Laundry detergents and cleaning supplies were observed in the garage in a locked cabinet. Garage doors are locked away from clients. There was a living/family room with adequate seating for all clients and a working TV. An adequate supply of linens was stored in a cabinet in the hallway of the residence.

Yards/Outside: Patio furniture for outdoor seating observed. Self-latching handle gate on left side of the house leads into the backyard. All outdoor pathways were free of obstructions. There is a swimming pool in the backyard which is locked with a gate and fence around the pool.

Record Review: Two (2) client files were reviewed for admission agreements, physician's reports, appraisals, P&I records, needs and services plans. Two (2) staff files were reviewed Crisis prevention interventions and First Aid/CPR certifications, criminal record clearances, personal record/history, training and health screenings, file review was complete. The facility maintains a surety bond, infection control plan, and disaster/emergency plan for review.

Facility sketches were observed posted near the main entrance. There was Let-Us-No poster, emergency disaster, personal rights, and Labor Laws observed.

NAME OF LICENSING PROGRAM MANAGER: Efren Malagon
NAME OF LICENSING PROGRAM ANALYST: Beena Singh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SULE'S LOVING HOME
FACILITY NUMBER: 365530354
VISIT DATE: 05/15/2026
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Two(2) fire extinguishers were charged and located down stairs and upstairs. Two (2) combined smoke detectors and carbon monoxide detectors were tested and were observed to be in working order. Medications, Client records and staff records are stored in a locked under the stairs cabinet in the hallway. First Aid kit with required components, and locked area for medication storage was observed.

There are enough Emergency water supply and the required 72-hour emergency food supply available at the facility. The facility was evaluated in accordance with the California Code of Regulations (CCR), Title 22, Division 6, Chapters 1 and 6 to ensure the health and safety of clients in care.

Fire drill was conducted on 05/13/2026 and earthquake drills conducted on 01/07/2026.

Liability insurance/workers Compensation is valid through 09/20/2025 to 09/20/2026.

Surety bond is effective since December 17th, 2024.

During today's visit, no deficiency was cited per Title 22 of the California Code of Regulations.

An exit interview was conducted, and a copy of this report, LIC809 was discussed and provided to Licensee/Administrator Sulema E Parra.

NAME OF LICENSING PROGRAM MANAGER: Efren Malagon
NAME OF LICENSING PROGRAM ANALYST: Beena Singh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2026
LIC809 (FAS) - (06/04)
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