Senior Care Records.

Facility Evaluation Report

Delta Residential Home, Moreno Valley06/10/2025Licence 336403222

Capacity6
Census2
Date signed06/10/2025 11:59:12 AM
Name of licensing program analystDebbie Palacios
Name of licensing program managerRikesha Stamps
The inspector’s account

Licensing Program Analysts (LPAs) Debbie Palacios and Janira Arreola met with Caregiver Mearlene Martin in order to conduct a Plan of Correction (POC) Visit. LPAs conducted records review and interviews. At the time of the visit, LPAs observed three (3) clients and one (1) client was visiting from another facility.

The following deficiency was not corrected by the POC due date nor at the time of the visit. Civil Penalties are being assessed and will continue to accrue until the POC has been submitted:

A deficiency was cited for California Code of Regulations (CCR) 80063(a)(1) for not having an active governing body, as Community Valley Homes INC. is in a stated of forfeiture with the Franchise Tax Bureau (FTB). The licensee agreed to submit documentation showing good standing with the FTB by the POC due date of 02/14/2025. On today's date the FTB status is still showing in a state of forfeiture and proof of good standing has not been submitted. Therefore, the POC has not been met and civil penalties are being assessed in the amount of $100 per day for twelve (12) days from 05/30/2025 to 06/10/2025.

The licensee was advised that civil penalties will continue to accrue until the POC has been received.

The following deficiencies were observed during today's visit. Based on interview and record review, the licensee did not comply to protect client's personal medical information private which poses an immediate health, safety or personal rights for persons in care. S1 was present at the facility during a doctor's telephone call conference and was going to transport clients to the day care without finger print clearances

An exit interview was conducted and a copy of the report was reviewed and provided.

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