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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880552
Report Date: 10/23/2023
Date Signed: 10/23/2023 12:55:26 PM

Document Has Been Signed on 10/23/2023 12:55 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:CURA AMOREFACILITY NUMBER:
331880552
ADMINISTRATOR:VITO, ANNA BELLAFACILITY TYPE:
740
ADDRESS:2394 MONTEREY PENINSULA DRTELEPHONE:
(626) 423-9194
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY: 6CENSUS: 6DATE:
10/23/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Anna Bella Vito, administratorTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility, as a case management visit, to have the Administrator Vito sign an amended complaint #56-AS-20220502165138. LPA Prieto toured the facility with Administrator. The facility has 6 clients at the home during this visit. LPA Prieto and Ms Vito signed the complaint report and a copy with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2023
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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