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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336426273
Report Date: 08/21/2024
Date Signed: 08/22/2024 04:27:29 PM

Document Has Been Signed on 08/22/2024 04:27 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:DESERT COTTAGE IIIFACILITY NUMBER:
336426273
ADMINISTRATOR/
DIRECTOR:		HENGSTLER, ELIZABETHFACILITY TYPE:
740
ADDRESS:43745 PETTIROSSO ST.TELEPHONE:
(760) 342-7767
CITY:INDIOSTATE: CAZIP CODE:
92203
CAPACITY: 6CENSUS: 0DATE:
08/21/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Administrator Elizabeth HengstlerTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 8/21/24 Licensing Program Analyst's (LPAs) Valerie Flores, Ferrer Sabarias, and Andrei Castillo conducted an unannounced one (1) year required visit. LPA's were granted entry by Administrator, Elizabeth Hengstler, who was informed of the purpose of visit. At the time of visit, there are no residents in care. Per Elizabeth, they wish to admit residents once their fire sprinklers have been installed. Elizabeth has obtained proper fingerprint clearance and association to the facility. LPA's observed the following during today's visit:

LPA's conducted a tour of the facility with Administrator, Elizabeth. The physical plant contained four (4) resident bedrooms, one (1) staff bedroom, and three and a half (3.5) bathrooms. The facility has a dining room, kitchen, living room, and a gated backyard. Indoor and outdoor passageways were free of obstruction. There were no bodies of water located on the property. The facility has a working refrigerator ready for residents to be accepted into the facility. Water temperature measured at 120-degree Fahrenheit meeting within the required limits. Dishes and utensils were in sufficient supply and in good repair. Knives and sharp items are located in the kitchen in a locked cabinet. Resident bedrooms had the required bedding, furniture, and lighting. Disinfectants and cleaning solutions were secured in a locked cabinet in the kitchen. There is a locked cabinet located in the kitchen to store centrally stored medication. The smoke and carbon monoxide detectors were tested and were observed to be operable. LPA's observed charged fire extinguishers mounted in the kitchen. Facility maintained a sufficient amount of PPE located in the locked staff bedroom.



Administrator file reviewed have a criminal record clearance and valid first aid/CPR certification. Administrator’s license expiration date is 12/25/2024. Facility sketch, personal rights, and emergency disaster plan is posted on a wall in the hallway near entrance. According to Administrator, Elizabeth, there are no firearms or ammunition on the premises.

During today's visit, LPA's did not observe any immediate violations or concerns. An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator, Elizabeth Hengstler.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE: DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/21/2024
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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