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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366411220
Report Date: 12/04/2024
Date Signed: 12/04/2024 09:25:05 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/04/2024 09:25 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 ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:TUPARAN RESIDENTIAL CARE FACILITY, INC.FACILITY NUMBER:
366411220
ADMINISTRATOR/
DIRECTOR:
TUPARAN, LORETAFACILITY TYPE:
740
ADDRESS:855 FRONTIER AVETELEPHONE:
(909) 798-3439
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/04/2024
TYPE OF VISIT:Required - 1 YearANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:52 AM
MET WITH:Administrator Lori TuparanTIME VISIT/
INSPECTION COMPLETED:
09:35 AM
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Licensing Program Analysts (LPAs) Sarina Ramirez and Becky Mann and conducted an announced visit to the facility to conduct a required comprehensive annual inspection. LPA was greeted and granted entry by the Administrator Lori Tuparan.

The facility is an Residential Care Facility for the Elderly (RCFE) with a license capacity of (6) and current census of (0). LPAs conducted an overall inspection of the facility, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by the Community Care Licensing Division (CCLD). Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. Four (4) resident bedrooms inspected were furnished with clean bed linen, mattresses, night stands, chairs, storage space, and sufficient lighting. Two (2) resident bathrooms were observed clean and fixtures were operating properly. The hot water temperatures in the bathrooms measured 110 and 115 degrees F. The facility maintains a sufficient supply of bed linens and towels. The facility has a locked cabinet where medications will be centrally stored. The facility is equipped with operating laundry equipment and telephone service. Posters such as resident personal rights, facility sketch, Community Care Licensing complaint poster, Ombudsman poster, and facility license were posted in a common area.

Food Service: Kitchen and dining areas were maintained clean. The facility has a sufficient space for non-perishable and perishable foods. The facility refrigerator and freezer were maintained in healthful manner.

Karen ClemonsTELEPHONE: (951) 836-2784
Sarina RamirezTELEPHONE: (951) 248-0307
DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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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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: TUPARAN RESIDENTIAL CARE FACILITY, INC.
FACILITY NUMBER: 366411220
VISIT DATE: 12/04/2024
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Overall the facility is maintained clean and in good repair. No deficiencies were cited during today's inspection.

An exit interview was conducted where this report was discussed and a copy provided to Administrator Lori Tuparan at the conclusion of the visit.

SUPERVISOR'S NAME: Karen ClemonsTELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Sarina RamirezTELEPHONE: (951) 248-0307
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
LIC809 (FAS) - (06/04)
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