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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 371881555
Report Date: 03/04/2025
Date Signed: 03/04/2025 11:13:38 AM

Document Has Been Signed on 03/04/2025 11:13 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:ALIVE COMFORT CARE #1FACILITY NUMBER:
371881555
ADMINISTRATOR/
DIRECTOR:		CARRERA, TERESA LOURDESFACILITY TYPE:
735
ADDRESS:2204 WEATHERBY AVETELEPHONE:
(619) 882-6669
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 4CENSUS: 0DATE:
03/04/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Licensee, Teresa CarreraTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 03/04/2025, Licensing Program Analyst (LPA) Debbie Palacios conducted an announced visit to the pending facility to conduct a pre-licensing inspection. LPA met with Applicant Teresa Carrera and BCBA Sarai Marcelin. Fire clearance has been granted for four (4) ambulatory clients and the facility will serve adults ages 18 through 59. Applicant Teresa's Administrator certificate expires on 12/20/26.

LPA conducted of a tour of the facility’s interior and exterior. LPA did not observe any clients residing in the home or evidence to suggest the home is currently occupied. The facility is made up of a one-story home with three (3) client bedrooms; one (1) will be a shared bedroom, two (2) client bathrooms, a kitchen, living/family room, and a garage. LPA did not observe bodies of water on the premises. The physical plant is in good repair. Indoor and outdoor passageways are free of obstruction. An outdoor shaded seating area is available for future clients; there is a locked shed storage that contains garden tools. LPA observed one (1) charged fire extinguisher last serviced on 08/02/24. LPA tested the smoke alarms and carbon monoxide detectors and found them to be operational. The facility also has a working telephone. LPA observed that the garage has a the washer and dryer area, detergents and cleaning solutions are stored in a cabinet, there is a locked cabinet area for client and staff files, centrally stored medications, and knives/sharp instruments; the garage is locked at all times.

Client bedrooms had the required bedding, furniture, closet storage, and functional lighting. Additional linen and towels are available for future clients.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ALIVE COMFORT CARE #1
FACILITY NUMBER: 371881555
VISIT DATE: 03/04/2025
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Continued from LIC809..

LPA toured the kitchen and observed that food was stored in a safe and healthful manner. The facility had a 2-day supply of perishable food items and 7-day supply of nonperishable food items. Emergency food, water and essentials are stored in the garage.

LPA toured the bathrooms and observed bathrooms to be in safe and sanitary conditions. The hot water temperature in the client bathrooms measured at 108-degrees Fahrenheit. LPA observed new hygiene kits stored in a hallway closet.

Living/family room has a working television and adequate seating in common areas. The facility has a central heating and air conditioning system installed with a central panel located in the hallway to control entire house.

Emergency disaster plans, personal rights, and complaint procedures were posted in the hallway wall. LPA observed a complete first aid kit and manual.

During today’s visit, LPA did not observe any issues or concerns. Licensee has completed COMP III and final approval of licensure will be granted by the Centralized Application Bureau analyst.



An exit interview was conducted where a copy of this report was discussed and provided.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
LIC809 (FAS) - (06/04)
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