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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372008467
Report Date: 11/25/2024
Date Signed: 11/25/2024 02:27:43 PM

Document Has Been Signed on 11/25/2024 02:27 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:DOWNSTOWN IVFACILITY NUMBER:
372008467
ADMINISTRATOR/
DIRECTOR:		SUSAN LAUBACHFACILITY TYPE:
735
ADDRESS:1710 REES ROADTELEPHONE:
(760) 746-2111
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 6CENSUS: 0DATE:
11/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Kecia Stinnett, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
02:35 PM
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On 11/25/2024, Licensing Program Analyst (LPA), Janette Romero made an unannounced case management visit to follow up with the facility regarding the fire that occurred in the home on 9/24/2024. LPA met with Executive Director (ED), Kecia Stinnett who was informed of the purpose of the visit. ED reported all the clients previously residing in the home were immediately and appropriately relocated. LPA toured the facility with ED and observed fire debris and black smoke damage to the outside wall and self latching door located on the right side of the home near the garage. ED reported currently, the home is not habitable since there is no electricity or gas available at the facility (only water) due to the fire damage. ED added there is also a strong smoke odor lingering throughout the home and the facility requires several permits and repairs before it is safe for clients to return to the home. ED reported the cause of the fire is currently under investigation and the extent of the damages are unknown. ED added any updates they receive will be provided to the Department. An exit interview was conducted and a copy of this report was reviewed and provided to ED.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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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