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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 371881578
Report Date: 09/24/2024
Date Signed: 09/24/2024 10:59:19 AM

Document Has Been Signed on 09/24/2024 10:59 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:WINGS RECOVERY CENTER, LLCFACILITY NUMBER:
371881578
ADMINISTRATOR/
DIRECTOR:		HOLSAR, KATYFACILITY TYPE:
735
ADDRESS:2124 OPAL RIDGETELEPHONE:
(858) 220-9519
CITY:VISTASTATE: CAZIP CODE:
92081
CAPACITY: 6CENSUS: 0DATE:
09/24/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Administrator - Katy HolsarTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Sara Martinez conducted an announced visit to the facility for the purpose of a Pre-Licensing inspection. LPA met with Administrator Katy Holsar and Sherry Hoeckendorf and was granted entry. Fire clearance was granted on 03/22/2024 for a total of six (6) clients. LPA observed the following:

Facility is a two-story building with three (3) client bedrooms, three (3) bathrooms, a staff office, two (2) living room areas, a dining area, and a kitchen. LPA observed clients bedrooms with the required bedding and furniture, such as, clean mattresses/linen, nightstands, dressers, chairs, lighting, and emergency lighting. Client bathrooms had clean appliances that were operating in safe and sanitary condition. Hot water temperature met department requirement. Facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. Facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods.
Client and staff files will be located in a cabinet in the staff office. Client medication will be centrally stored and locked in medcarts located in the staff office. The facility does not have any bodies of water on the property. There is a covered area with seating for the all the clients. All passageways were free from obstruction. LPA observed multiple charged fire extinguisher in the facility. Multiple smoke detectors and carbon monoxide alarms were operational. The facility does not have any firearms and ammunition on the property. LPA observed required postings including the visitation polices, emergency/disaster plans, complaint procedures, and personal rights. Facility contains emergency supplies and first aid kits with the required items. The facility has working telephone for client use.

LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA determined the facility meets the operational requirements for licensure. The Pre-licensing inspection is complete, and this facility has no deficiencies. The facility has satisfied all requirements in accordance with Title 22, California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Administrator Holsar.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2024
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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