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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600611
Report Date: 01/28/2025
Date Signed: 01/28/2025 11:13:38 AM

Document Has Been Signed on 01/28/2025 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:HOOVER ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
374600611
ADMINISTRATOR/
DIRECTOR:		ELAINE CORVILLAFACILITY TYPE:
735
ADDRESS:1150 HOOVER STREETTELEPHONE:
(760) 294-3069
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 6CENSUS: 6DATE:
01/28/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Elaine Corvilla, Administrator TIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 1/28/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1 year required visit. LPA was greeted and granted entry by Client #1 (C1), and was met by Caregiver Elvira Corvilla where LPA explained the purpose of the visit. At the time of the visit there was (2) staff and (5) clients present. The Administrator Elaine Corvilla arrived shortly after LPAs arrival.
LPA conducted a tour of the interior and exterior areas of the facility. The medications were observed to be locked and inaccessible to clients in care. Per the medication authorization record the medications are being given according to physician instructions. The facility was observed to be clean and clutter free, the appliances were observed to be operable. The smoke and carbon monoxide detectors were tested and observed to be operable. The facility was observed to have a sufficient food supply (2 day of perishable and a 7 days supply of non perishable food items). There were 4 cans of expired chilli that were discarded during LPAs visit, therefore no citation was issued. The clients handle their own money, therefore no P& I was reviewed.
Staff records review the facility staff were observed to have proper obtained fingerprint clearance and to be associated to the facility. in addition there was valid CPR certification, that expires on 5/15/25. The administrator Elaine Corvilla currently possess a valid administrator certificate that expires on 5/14/25.

Prior to today's inspection a facility file review was conducted, LPA observed for the facility annual licensing fees to not have been paid, as they were due on or before 1/12/25 for the amount of $454.00 Per Administrator Elaine they were not paid, as she is planning on retiring and going through a change of ownership, and thought that it was going to be processed in December 2024. LPA reminded Administrator that the new license has not been issued and the facility is to remain in compliance which would include the licensing fees. The fees were paid during today's visit. The facility is conducting emergency disaster drills on a monthly basis and the last drill conducted was in December 2024. Based on today's inspection there were no citations issued. An exit interview was conducted and a copy of this report was provided to Elaine Corvilla, Administrator.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
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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