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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881147
Report Date: 11/27/2024
Date Signed: 11/27/2024 09:31:07 AM

Document Has Been Signed on 11/27/2024 09:31 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
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:TRINITY WAY ASSISTED LIVING FACILITYFACILITY NUMBER:
331881147
ADMINISTRATOR/
DIRECTOR:		HAMILTON LIGON, KIMBERLY DFACILITY TYPE:
740
ADDRESS:7015 COLLEGE PARK DRIVETELEPHONE:
(323) 806-2313
CITY:CORONASTATE: CAZIP CODE:
92880
CAPACITY: 6CENSUS: 0DATE:
11/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Administrator Kimberly Hamilton LigonTIME VISIT/
INSPECTION COMPLETED:
09:40 AM
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Licensing Program Analyst (LPA) Raquel Hernandez arrived to the facility to conduct an annual required visit. LPA met with Administrator Kimberly Hamiliton Ligon. LPA learned that the facility has not retained any clients at this time. Administrator Kimberly Hamilton is in the process of changing location and does not plan on accepting any residents at this location.

The facility is an Residential Care For The Elderly (RCFE). Licensed capacity is (6) current census (0). LPA was accompanied by Administrator Kimberly Hamilton Ligon to conduct a general overall inspection.

LPA advised Administrator Kimberly Hamilton Ligon that the facility will be reassessed for compliance once change of location is granted.

Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Kimberly Hamilton Ligon.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2024
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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