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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881115
Report Date: 05/07/2024
Date Signed: 05/07/2024 11:17:01 AM

Document Has Been Signed on 05/07/2024 11:17 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:ANGEL'S LOVING TOUCHFACILITY NUMBER:
331881115
ADMINISTRATOR/
DIRECTOR:
CERDA, YAZMIN S.FACILITY TYPE:
740
ADDRESS:37212 EDGEMONT DRIVETELEPHONE:
(951) 249-9041
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY: 6CENSUS: 6DATE:
05/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:08 AM
MET WITH:ADMINISTRATOR, YAZMIN CERDA.TIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On May 07, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Required Annual Inspection and met with the Administrator, Yazmin Cerda. The facility file review was conducted at the Regional Office and additional forms were requested and reviewed on site. The facility is operating at the full capacity of six Elderly Adults, (740).

LPA Mixson toured the facility along with the Administrator and inspected the facility inside and outside, and there were no obstructions to the indoor or outdoor passageways at the time of this visit. The facility is a single-story home located at 37212 Edgemont Drive, Murrieta, CA 92563.

Physical Plant: The facility phone number is (951) 249-9041 and it is operable. The LPA observed the residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected 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 LPA observed required postings such as "If you See Something, Say Something" the "Personal Rights" and the Ombudsman postings. The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care currently. The overall facility is clean, the furniture is in good condition. The facility heating system and other appliances were operable at the time of this visit, and there were safety lights for night. Medications: Were locked and inaccessible to residents in care, and there was a sufficient supply of medication for each resident. There were no observable missed medications, or errors reviewed at this time. Food Service: The non-perishable and perishable food supply are sufficient per regulations, and there are a variety of food types available for residents at the time of this visit. Dishes and utensils were in sufficient supply and stored properly, and sharps are locked. Care & Supervision: Facility has sufficient staff, two staff on site at the time of this visit, and the Administrator arrived shortly after the LPA for a total of three. Records Review: The LPA reviewed resident and staff files, conducted staff interviews, but residents were occupied with daily activities. Previous Community Care Licensing forms were reviewed. There were 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 given to the Administrator, Yazmin Cerda.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2024
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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