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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604106
Report Date: 11/08/2024
Date Signed: 11/08/2024 12:52:45 PM

Document Has Been Signed on 11/08/2024 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:AVID BEHAVIORAL DAY PROGRAM VISTAFACILITY NUMBER:
374604106
ADMINISTRATOR/
DIRECTOR:		MAHARAI, LORENAFACILITY TYPE:
775
ADDRESS:1221 WEST VISTA WAYTELEPHONE:
(760) 691-9622
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY: 60CENSUS: 38DATE:
11/08/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Facility Manager, Dalia ManriquezTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 11/8/2024, Licensing Program Analyst (LPA), Janette Romero conducted an unannounced collateral visit to the day program to conduct an interview with Client 1 regarding an open complaint against a different licensed facility. LPA met with Facility Manager (FM), Dalia Manriquez who was informed of the purpose of the visit.

LPA toured the facility, conducted interviews, and obtained copies of pertinent records. During the tour, LPA observed 38 clients in care and 14 care staff present. An exit interview was conducted an a copy of this report was reviewed and provided to FM Manriquez.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
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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