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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 037003701
Report Date: 07/10/2024
Date Signed: 07/10/2024 04:51:54 PM

Document Has Been Signed on 07/10/2024 04:51 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:FERRER HOME CARE, LLCFACILITY NUMBER:
037003701
ADMINISTRATOR/
DIRECTOR:
FERRER, ROSEMARIEFACILITY TYPE:
735
ADDRESS:614 SUTTER LANETELEPHONE:
(209) 274-0899
CITY:IONESTATE: CAZIP CODE:
95640
CAPACITY: 6CENSUS: 4DATE:
07/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Aaron CocjinTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 7/10/24 at 2:45pm Licensing Program Analyst (LPA) Arvin Villanueva arrived to the facility unannounced to conduct an annual visit. LPA initially met with facility staff, and stated the purpose of the visit. The home manager, Aaron Cocjin, was notified of the visit and arrived shortly after. Today's visit, there were 4 clients in care with 1 staff on duty.

LPA toured the facility with staff on duty. LPA observed common areas to be clean and free from debris and obstructions. Three resident bedrooms were observed to be fully furnished and free of malodor. Two bathrooms were equipped with soap, paper towels, and a lid trash can. The facility is fully furnished. The room temperature was observed at 75 degrees F. Hot water temperature was taken in both bathrooms and was observed to be at 107 degrees F. The kitchen was observed to be clean and sanitary. The facility maintains nonperishable foods for a minimum of 7 days and perishable food for 2 days. The garage houses additional freezer, washer and dryer, and locked cabinets for chemicals. Two fire extinguishers are maintained in the facility and were observed to be charged and last serviced on 12/8/23. Medications, cleaning supplies, and sharp objects were locked and inaccessible to residents in care. LPA conducted facility record review, 5 staff records review, and 4 client records review. All were observed to be in compliance. Additionally, LPA conducted medication review of 4 of 4 clients in care and were observed to be in compliance. Facility handles 3 of 4 clients money. LPA and facility manager counted 2 of 4 clients money and no issues were noted.

LPA requested the following documentation to be emailed to LPA: LIC 500, LIC 308, Surety Bond, and liability insurance.

Per California Code of Regulations, Title 22, Division 6, Chapter 6, no deficiencies were observed during this visit. An exit interview was held with Aaron Cocjin, and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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