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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604258
Report Date: 02/27/2024
Date Signed: 02/27/2024 02:24:15 PM


Document Has Been Signed on 02/27/2024 02:24 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:ALDINE RESIDENTIAL CAREFACILITY NUMBER:
374604258
ADMINISTRATOR:ADAYA, GERALDINEFACILITY TYPE:
740
ADDRESS:794 MARSOPA DRTELEPHONE:
(858) 216-5613
CITY:VISTASTATE: CAZIP CODE:
92081
CAPACITY:0CENSUS: 6DATE:
02/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ariel Remot - House ManagerTIME COMPLETED:
02:36 PM
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Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to deliver an amended copy of a previously issued report. LPA met with house manager Ariel Remot, and explained the purpose of the visit. LPA conducted an exit interview and reviewed and provided copies of the amended report Ariel Remot.

Nothing further is needed at this time.
SUPERVISOR'S NAME: Rikesha StampsTELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 248-0314
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2024
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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