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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881057
Report Date: 07/12/2024
Date Signed: 07/12/2024 12:35:22 PM

Document Has Been Signed on 07/12/2024 12:35 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
RIVERSIDE, CA 92507
FACILITY NAME:VIEWMONT ACRESFACILITY NUMBER:
331881057
ADMINISTRATOR/
DIRECTOR:		O'REILLY, DENISEFACILITY TYPE:
740
ADDRESS:29290 VALLEJO AVETELEPHONE:
(951) 506-8206
CITY:TEMECULASTATE: CAZIP CODE:
92592
CAPACITY: 6CENSUS: 0DATE:
07/12/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:38 AM
MET WITH:CORA BELLOSILLO, VOLUNTEERTIME VISIT/
INSPECTION COMPLETED:
12:48 PM
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On July 12, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to conduct a Required Annual Inspection and met Cora Belleville, (Aunt of Administrator, Denise O'Reilly). LPA spoke with Administrator via the tele phone and was informed that there are zero resident residing at the facility currently and no staff. The facility file review was conducted in the Regional Office. The facility is licensed for six Adults but current has no residents. Facility type is Residential Care Elderly (740).

LPA Mixson toured the facility along with Cora Bellosillo and made observations pertaining to the one year required annual. The facility was inspected inside and outside, there were no obstructions or debris to the indoor or outdoor passageways currently. The facility is a single-story home located at 29290 Vallejo Ave Temecula, CA 92592.

Physical Plant: The facility phone number is (707) 287-0118 and is currently operable. LPA Mixson observed all five residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected the five facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. The cleaning supplies and sharp items were kept locked. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to future residents. There was a swimming pool, and it is secured and meets regulations. Fireplace is screened and meets regulations.

Medications: LPA observed where medications are to be locked and inaccessible. Food Service: Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked. Care & Supervision: Facility has no staff currently and no residents as of today’s visit. Records Review: There were no records reviewed today due to the Administrator being out of town on today’s visit.

There was no Title 22, Division 6 Regulation violations observed or cited during today’s visit.

An exit interview was conducted, and a copy of this report was discussed and given to Cora Bellosillo.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2024
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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