Senior Care Records.

Facility Evaluation Report

Perry's Residential Facility, INC, Moreno Valley04/04/2025Licence 331800240

Capacity5
Census4
Date signed04/04/2025 04:14:41 PM
Name of licensing program analystVenus Mixson
Name of licensing program managerJazmond D Harris
The inspector’s account

On April 04, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Required Annual Inspection and met with the Administrator, Andy Adams. The facility file review was conducted at the Regional Office and additional records were requested and reviewed on site. The facility is licensed for five Adults and is currently operating at a capacity of four Adults (735).

LPA Mixson toured the facility along with the Administrator, Andy Adams and made observations pertaining to the annual visit. LPA inspected the facility inside and outside there were no obstructions or debris to the indoor or outdoor passageways at the time of this visit. Additionally, there were no bodies of water on the premises. The facility is a single-story home located at 13141 Windsong Road Moreno Valley, CA. 92555

Physical Plant: The facility phone number is (951) 455-4114 and it is operable. LPA Mixson observed the residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations at. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguisher, was reviewed in February 2025 by Elite. LPA Mixson observed required postings such as "If you See Something, Say Something,” the "Personal Rights," and the PUB 475. The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care currently at the time of this visit.

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