Senior Care Records.

Facility Evaluation Report

Divine Residential INC, Lake Elsinore11/04/2024Licence 331881143

Capacity4
Census3
Date signed11/04/2024 12:12:03 PM
The inspector’s account

On 11/04/2024 at 09:45 AM, Licensing Program Analyst (LPA) Melody Brown met with staff Jennifer Iwu to initiate a Case Management Visit. Administrator Olayinka King was contacted and informed of the visit. The investigation consisted of observation, interviews, and a review of pertinent documentation.

During the tour of the facility, LPA Brown observed the facility does not have the required minimum of seven (7) days of nonperishable foods maintained at the facility. LPA Brown Brown informed staff Iwu that the facility was cited for the same violation on Food Service 85076(d)(1) on 09/09/2024. Civil Penalty of $250.00 will be assessed today and will continue to be assessed of $100.00 per day if not corrected.

An exit interview was conducted, where this report, LIC809, LIC809D, LIC421FC and Appeal Rights were discussed and provided to staff Jennifer Iwu.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction