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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366402422
Report Date: 01/17/2023
Date Signed: 01/17/2023 12:59:34 PM

Document Has Been Signed on 01/17/2023 12:59 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:OPARC SUMMIT SERVICESFACILITY NUMBER:
366402422
ADMINISTRATOR:RODNEY TURNERFACILITY TYPE:
775
ADDRESS:436 SOUTH SULTANATELEPHONE:
(909) 920-5204
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY: 60CENSUS: DATE:
01/17/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Rodney Turner, Program ManagerTIME COMPLETED:
01:15 PM
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1130: Licensing Program Analyst (LPA) Amy Goldenberg arrived to this facility to conduct an interview with C1. C1 was unavailable at this time and was expected to return at approximately 1230. LPA will return to complete this visit.

1230: LPA arrived back to the facility and was greeted at the yard of the facility by Program Manager Rodney Turner. The purpose of this visit is for LPA to interview C1 in relation to a complaint investigation being conducted at another licensed facility. During this visit LPA interviewed C1. LPA reviewed this report with the facility representative and provided a copy prior to leaving.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amy Goldenberg
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023
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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