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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881818
Report Date: 02/10/2026
Date Signed: 02/10/2026 10:07:37 AM

Document Has Been Signed on 02/10/2026 10:07 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:GOOD FAITH SENIOR CAREFACILITY NUMBER:
331881818
ADMINISTRATOR/
DIRECTOR:		GARCIA, DANIELLEFACILITY TYPE:
740
ADDRESS:25705 ONATE DR.TELEPHONE:
(951) 822-2709
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY: 6CENSUS: 0DATE:
02/10/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Applicant Danielle GarciaTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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
On 02/10/2026, Licensing Program Analyst (LPA) Janette Romero made an announced visit to the home to conduct a pre-licensing inspection. On 08/01/2025, an initial application was received by the Centralized Applications Bureau (CAB) to operate a Residential Care Facility for the Elderly in the home. LPA met with Applicant, Danielle Garcia whose administrator’s certificate expires on 03/22/2027. LPA reviewed a signed Fire Safety Inspection Request (STD. 850) dated 10/10/2025, noting the home was granted a fire clearance to serve six elderly residents. Specifically, four (4) ambulatory, one (1) non-ambulatory and one (1) bedridden, ages 60 and above.

LPA toured the facility's interior and exterior with Applicant Garcia. The facility is made up on a one-story home with four resident (4) bedrooms, two (2) bathrooms, a kitchen, dining room, living room, staff office, and attached car garage. The home has operating utilities. Indoor and outdoor passageways are free of obstruction. Outdoor shaded seating is available for the requested capacity. The home has an in-ground pool that is fenced. Applicant Garcia tested one of the smoke alarms/carbon monoxide detectors and LPA heard them to be operational. There is a central heating and air conditioning system installed in the home with a central panel located in the hallway to control the entire house. All resident bedrooms are adequately furnished with a bed, chair, drawer/closet space and functional lighting. Bathrooms have a working toilet, wash basin, and have toilet paper, paper towels, and soap readily available. LPA also observed shower chairs and grab bars in the showers. LPA toured the living and dining room and observed there sufficient seating for the requested capacity. LPA toured the kitchen and observed a two-day supply of perishable foods and seven-day supply of non-perishable food items.

NAME OF LICENSING PROGRAM MANAGER: Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST: Janette Romero
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2026
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 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: GOOD FAITH SENIOR CARE
FACILITY NUMBER: 331881818
VISIT DATE: 02/10/2026
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
26
27
28
29
30
31
32
Knives and sharp instruments are secured in a locked safe in a kitchen cabinet. Disinfectants, laundry detergents, and cleaning solutions are secured in the locked garage. Medications will be centrally stored in a locked cabinet in the staff office. Confidential records will be stored in a file cabinet inside the staff office. LPA observed several bedding, linens, bath towels, body wash/soap, hand soaps, books and board games available for future residents in care. Emergency phone numbers and disaster plan, residents’ personal rights, complaint procedures and facility sketch are visibly posted near the front entrance. During today's visit, LPA did not observe any issues or concerns, and no corrections are required. Applicant Garcia completed the COMP III requirement at the Riverside Regional Office on 01/13/2026. Final approval of licensure will be granted by the CAB analyst. An exit interview was conducted, and a copy of this report was reviewed and provided to Applicant Garcia.
NAME OF LICENSING PROGRAM MANAGER: Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST: Janette Romero
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
LIC809 (FAS) - (06/04)
Page: 3 of 3