<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 037003701
Report Date: 08/15/2023
Date Signed: 08/15/2023 12:36:13 PM

Document Has Been Signed on 08/15/2023 12:36 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:FERRER HOME CARE, LLCFACILITY NUMBER:
037003701
ADMINISTRATOR:FERRER, ROSEMARIEFACILITY TYPE:
735
ADDRESS:614 SUTTER LANETELEPHONE:
(209) 274-0899
CITY:IONESTATE: CAZIP CODE:
95640
CAPACITY: 6CENSUS: 4DATE:
08/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Nathan YesowitchTIME COMPLETED:
12:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct an annual required visit. LPA called Administrator Rosemarie. Administrator informed LPA that the residents were in day program. LPA met with facility staff, and explained the purpose of the visit. Administrator gave facility staff permission to sign on her behalf.

LPA toured the facility with staff Nathan Yesowitch. LPA observed residents to be away from the facility and attending Day Program. LPA observed the common areas, kitchen, 4 resident bedrooms, 1 staff bedroom, garage, sheds, and backyard area. Resident and staff bedrooms were equipped with required furniture and furnishings. Resident bathrooms were fully stocked with paper towels, soap, hand sanitizer, trash cans, and handrails. Hot water in the bathroom was measured at 108.9*F. The facility temperature was 77*F throughout the home. Common areas were observed to be clean and free from debris. There was a living room area for residents to use to play guitar, darts, watch television, and have visits. The backyard was clean and free from debris. LPA observed fire extinguishers to be fully charged and in working condition.

LPA reviewed resident and staff files. Staff file was up to date with required training. Resident files were observed to be current with necessary documentation. Last emergency drill was conducted on 08/05/2023.

LPA requested the following documentation be sent to LPA by 08/18/2023: LIC 500, LIC 308, LIC 610D, Surety Bond

Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 6, no deficiencies were observed. An exit interview was held, and a copy of the report was provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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 1