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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881643
Report Date: 12/16/2024
Date Signed: 12/16/2024 12:15:03 PM

Document Has Been Signed on 12/16/2024 12:15 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:NANA NIDA'S HAVENFACILITY NUMBER:
331881643
ADMINISTRATOR/
DIRECTOR:		GERADA, J NIDAFACILITY TYPE:
740
ADDRESS:31-760 AVENIDA DEL PADRETELEPHONE:
(760) 219-7868
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY: 6CENSUS: 4DATE:
12/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:40 AM
MET WITH:Rey Gerada, caregiverTIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced case management visit to the above facility. LPA met with Rey Gerada, caregiver, and explained the purpose of today’s visit, to follow up on a facility closure for Mary Grace Loving Care (#331880842).

During the visit LPA confirmed an application was submitted under Nana Nida’s Haven (#331881643) for a change of ownership. Nana Nida's Haven application was approved and was licensed on 11-05-2024. LPA toured the facility and there were no health and safety concerns observed.

Regional office will finalize the closing of Mary Grace Loving Care. LPA was able to obtain the original license of Mary Grace Loving Care during today’s visit.

An exit interview was conducted with Rey Gerada, and a copy of this report was provided.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Seo Jeon
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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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