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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 365530203
Report Date: 06/26/2024
Date Signed: 06/26/2024 10:20:29 AM

Document Has Been Signed on 06/26/2024 10:20 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:PLATINUM SKILL PROFESSIONALS, INC.FACILITY NUMBER:
365530203
ADMINISTRATOR/
DIRECTOR:		BARRETT, QUINNOLFACILITY TYPE:
740
ADDRESS:13625 SIERRA VISTA DR.TELEPHONE:
(888) 342-2732
CITY:VICTORVILLESTATE: CAZIP CODE:
92395
CAPACITY: 6CENSUS: 0DATE:
06/26/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Quinnol Barrett- LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:29 AM
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Licensing Program Analyst (LPA) Michelle Echeverria , arrived at Platinum Skill Professional, Inc., to conduct an announced Pre-Licensing visit for licensure. LPA was greeted by Licensee, Quinnoll Barrett. LPA introduced self and stated purpose of the visit. LIC200 application was submitted on 12/08/23 for (6) ambulatory residents. Fire Safety Inspection clearance was granted for (6) ambulatory residents on 02/23/24. LPA toured the facility inside and outside and observed the following:

Structure: Facility is a one story house with (3) resident bedrooms, (2) resident bathrooms, living room, dining area, kitchen, pantry, office, backyard, and attached garage.

Heating/Cooling System: Central heating and air conditioning system installed with a central panel located in the hallway to control entire house.

Bedrooms: Each resident bedroom accommodates two ambulatory residents.

Bathrooms: The resident bathrooms have a working toilet, wash basin, and shower with an adequate supply of toilet paper and soap.

Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots, and pans were observed. Knives, sharps, detergent and chemicals are stored in locked compartments. There was a pantry stocked with non-perishable food and perishable food found in the refrigerator. LPA observed the stove to be operational. Refrigerator/freezer were in working condition. Water tested in the bathroom faucet measured at 106.7 degrees fahrenheit. A functional washer and dryer is located inside the garage.

Living/Family room: There was a furnished living room with one enclosed fireplace, and tv observed.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Michelle Echeverria
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: PLATINUM SKILL PROFESSIONALS, INC.
FACILITY NUMBER: 365530203
VISIT DATE: 06/26/2024
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Linens and Hygiene Supplies: An adequate supply of linens and hygiene supplies stored in a closet.

Yards/Outside: A self-latching handle gate on the left side of the house that leads into the backyard. There are no firearms, ammunition, swimming pool or bodies of water observed. All outdoor pathways were free of obstructions.

Emergency Phone Numbers, and Exit Plan: CCL complaint poster, house rules, personal rights, Emergency and Disaster Plan and ombudsman were observed posted in the entrance wall.

General items: The smoke and carbon monoxide detectors were tested and are operable. There was fully charged fire extinguishers observed. Resident/Staff records stored in a locked filing cabinet inside the office. First Aid kit with required components, and a locked area for medication storage was observed. LPA observed a facility phone and was operational as evidenced by LPA dialing the number. The phone number designated for the facility is 760-780-0044.

Pre-Licensing and Component III are complete and facility is ready for licensure.


An exit interview was conducted, and this report was discussed and provided to Licensee, Quinnoll Barrett.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Michelle Echeverria
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC809 (FAS) - (06/04)
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