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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331800086
Report Date: 02/18/2025
Date Signed: 02/18/2025 03:48:02 PM

Document Has Been Signed on 02/18/2025 03:48 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:CALIFORNIA HOME FOR THE ADULT DEAF (CHAD)FACILITY NUMBER:
331800086
ADMINISTRATOR/
DIRECTOR:		DANNY BARRETTFACILITY TYPE:
740
ADDRESS:3615 CROWELL AVETELEPHONE:
(626) 701-8960
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY: 6CENSUS: 5DATE:
02/18/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Admianistrator Danny BarrettTIME VISIT/
INSPECTION COMPLETED:
03:57 PM
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Licensing Program Analyst (LPA) Armando Perez made an unannounced visit to the facility to conduct a case management-annual continuation visit to complete an annual inspection commenced on January 28, 2025. LPA identified himself and was granted entry into the facility by staff. LPA met with Administrator Danny Barrett, and discussed the purpose of the visit.

LPA referred Administrator to Technical Assistance and Administrator met with Analyst Michael Reber on Thursday February 13, 2025 for assistance with record files. LPA's continuation visit consisted of a tour of the facility, and a review of both resident and staff records. LPA observed files to be incomplete. Administrator stated that he will need more time citing that he was working on getting his staff to sign documents and he just had the consultation meeting with Michael the week prior. LPA communicated with Administrator the LIC forms needed to complete the staff and resident files and will have them ready by February 28, 2025.

Based on the information received during this visit today in the areas reviewed, there are no deficiencies that are being cited per Title 22, Division 6 of The California Code of Regulations.



This LIC 809 report was reviewed with the facility representative, and a copy was provided.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2025
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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