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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602001
Report Date: 06/27/2024
Date Signed: 06/27/2024 12:52:50 PM


Document Has Been Signed on 06/27/2024 12:52 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:SILVER TREE VILLAFACILITY NUMBER:
374602001
ADMINISTRATOR:MOHAMMAD ARABSHAHIFACILITY TYPE:
740
ADDRESS:1592 SILVER TREE LNTELEPHONE:
(760) 739-8393
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY:6CENSUS: 0DATE:
06/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Administrator, Mohammad ArabshahiTIME COMPLETED:
12:55 PM
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Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived unannounced at the above facility to conduct a required annual inspection. Upon arrival LPA noticed the gate was closed off and the property appeared vacant. LPA called Administrator, Mohammad Arabshahi who informed LPA the facility currently does not have any clients and is undergoing renovations. Administrator arrived to the property shortly and LPA was allowed entrance into facility. A overall tour of the facility was conducted to confirm there were no clients presently living there. LPA observed each bedroom contained required furniture but no personal belongings. The facility is not client occupied. The Administrator stated he had three clients and gave a 60-day notice on 4/1/24. Administrator stated he also faxed a copy of a letter notifying the Department the facility would be closing to the Licensing office in San Diego. LPA requested a copy of the letter and Licensee emailed a copy to LPA. LPA obtained names and contact information of each former client. Clients moved out on 5/21/24, 5/26/24 and 5/30/24. LPA was provided a copy of the 60-day eviction notice that was given to each client. Licensee informed LPA that he plans to still have same staff that is currently on file. LPA reviewed staff records and records are up to date. Licensee states he plans to reopen in September 2024 and will notify the Department of an exact date.

An exit interview was conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Jacqueline Shaw RossTELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:
DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2024
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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