<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604325
Report Date: 08/26/2024
Date Signed: 08/26/2024 10:36:04 AM


Document Has Been Signed on 08/26/2024 10:36 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:MARAMAFACILITY NUMBER:
374604325
ADMINISTRATOR:SANDISON, HEATHERFACILITY TYPE:
740
ADDRESS:727 ASCOT DRIVETELEPHONE:
(760) 505-3019
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:12CENSUS: 0DATE:
08/26/2024
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Heather Sandison - AdministratorTIME COMPLETED:
10:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Sara Martinez conducted an announced visit to the facility. The inspection is in response to the licensee initiating closure of the facility. LPA met with Administrator Heather Sandison, who was informed of the purpose of the visit.

LPA conducted a final inspection and walk through of the home. LPA observed the bedrooms, bathrooms, garage, front and back yard of the home. All residents were relocated by 06/30/2024 and LPA observed no evidence of residents in care at the time of the visit. The licensee no longer wishes to hold a license with the department. During the visit, the physical license was obtained by the LPA.

An exit interview was conducted with Administrator Sandison where this report was reviewed and provided to them. LPA will send a final closure letter to the licensee’s mailing address which was confirmed during the time of the visit.

SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara MartinezTELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:
DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1