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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336426228
Report Date: 10/20/2025
Date Signed: 10/21/2025 06:39:39 AM

Document Has Been Signed on 10/21/2025 06:39 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:ARIA BOARD AND CAREFACILITY NUMBER:
336426228
ADMINISTRATOR/
DIRECTOR:		MEZA, WALTERFACILITY TYPE:
740
ADDRESS:913 ARIA RD.TELEPHONE:
(951) 357-2025
CITY:HEMETSTATE: CAZIP CODE:
92543
CAPACITY: 6CENSUS: 4DATE:
10/20/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Administrator, Walter MezaTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On 10/20/2025, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced 1-year required visit to the facility. LPA was met with and greeted by caregiver, Alva Davis. LPA Flores introduced herself and was granted entry into the facility. A tour of the interior/exterior areas of the facility was conducted alongside caregiver Alva. During today's visit, LPA Flores observed the following:

The facility is a single-story structure which consisted of (5) five resident bedrooms, (3) three bathrooms, living room, laundry room, great room, dining room, kitchen, and garage. Resident bedrooms were equipped with the required bedding, furniture, seating, and functional lighting. The facility maintained a comfortable temperature throughout the facility. Bathrooms were equipped with the required grab bars and slip resistant mats. The kitchen area was clean and free of rubbish. Facility maintained the required (2) two-day supply of perishable foods and (7) seven-day supply of non-perishable foods. LPA observed knives and other sharp items in a locked cabinet underneath the kitchen sink. A locked cabinet was observed to store centrally stored medication near the kitchen/dining room area. Utensils and other dishware were in sufficient supply and in good repair. LPA observed a cabinet in the hallway to store activities, extra linen and towels for the resident in care. Water temperature measured at 108.9 degrees Fahrenheit. Indoor/Outdoor passageways were free of obstruction. LPA observed outdoor seating with adequate shading. Per Administrator, Walter Meza, there are no firearms and/or ammunition on the premises.


(Continue to LIC809C...)
NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Valerie Flores
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2025
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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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)
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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: ARIA BOARD AND CARE
FACILITY NUMBER: 336426228
VISIT DATE: 10/20/2025
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(Continuation from LIC809)

LPA observed the required postings throughout the facility; LPA observed the See Something Say Something poster, Personal Rights, facility license, administrator certification, disaster plan, and LTCO poster. Resident records review included but not limited to pre-admission appraisal, Functional Capabilities, appraisal, medical assessment, needs and service plans, personal rights, and signed admission agreements. Staff records included background clearance, health screenings, and personnel records. LPA Flores did not observed updated annual training's. Per Administrator, the last conducted training's were from 2023. Therefore, citations will be issued during today's visit.

An exit interview was conducted where a copy of this report, LIC811, LIC809-D and appeal rights were reviewed and provided to Licensee, Walter Meza.
NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Valerie Flores
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/21/2025 06:39 AM - It Cannot Be Edited


Created By: Valerie Flores On 10/20/2025 at 01:29 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ARIA BOARD AND CARE
FACILITY NUMBER: 336426228

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1569.625(2)
(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and records review, the licensee did not comply with the section cited above in (2) two out of (2) two staff not completing required annual trainings which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/03/2025
Plan of Correction
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Administrator Walter Meza agreed to read regulations Health and Safety Code sections 1569.625, 1569.69, and 1569.626. After reading said sections, Administrator will provide LPA a signed copy of an in-service sheet of the sections read along with the completed trainings certificate of Staff #1 and Staff #2.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Anthony Perez
NAME OF LICENSING PROGRAM MANAGER:
Valerie Flores
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2025


LIC809 (FAS) - (06/04)
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