<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881604
Report Date: 01/22/2025
Date Signed: 01/22/2025 02:15:06 PM

Document Has Been Signed on 01/22/2025 02:15 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:ASPIRE CARE HOME 2FACILITY NUMBER:
331881604
ADMINISTRATOR/
DIRECTOR:
CANTORIA, ROBERT FFACILITY TYPE:
740
ADDRESS:720 CHAMBERS STTELEPHONE:
(909) 569-2280
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 6CENSUS: 0DATE:
01/22/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:29 PM
MET WITH:Applicant, Robert CantoriaTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Anaylst (LPA) Janira Arreola conducted an announced Prelicensing Visit. LPA was granted entry by and met with, Applicant, Robert Cantoria who was informed of the purpose of the visit.

The applicant is seeking an initial license for a Residential Care Facility for the Elderly, for ages 60 and above. The facility is a (1) story home with resident rooms totaling (4) bedrooms and (2) bathrooms. Bedrooms have been approved by the local fire jurisdiction for (2) ambulatory and (4) non-ambulatory residents. There are no bodies of water, weapons or fire arms kept at the facility.
LPA observed the kitchen had cooking supplies and equipment in good working condition. The facility meets the required food supply. The knifes and cleaning supplies will be kept locked in the kitchen. The medications will be kept in a locked cabinet in the kitchen. The outdoor area was observed to be free of hazards and has an emergency exit. There are activity supplies for future residents to engage in. LPA observed the resident bedrooms had the required furniture and the bathrooms have grab bars and hygiene supplies for future residents. The hot water temperature was recorded at 115.3F and the carbon monoxide and smoke alarms are in working condition. The laundry room had cleaning supplies to do regular cleaning of the facility, and equipment in good working condition. There is a supply of linens and towels for future residents. The facility has areas designated for future staff and resident records. Required postings are found in the staff office, and emergency and PPE supplies were kept in the pantry. The facility is waiting on the land line service and an outdoor patio set. The Applicant stated they would have these items ready by Friday 01/31/2025. The LPA will be informed of the completion of these items before proceeding with being licensed.

An exit interview was conducted where this report was reviewed and provided to the applicant.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1