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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 126804181
Report Date: 01/08/2024
Date Signed: 01/08/2024 05:24:39 PM

Document Has Been Signed on 01/08/2024 05:24 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:RAMONA'S PLACE LLCFACILITY NUMBER:
126804181
ADMINISTRATOR:ANDREWS, JANAFACILITY TYPE:
735
ADDRESS:3111 BRIAN CTTELEPHONE:
(707) 599-9975
CITY:ARCATASTATE: CAZIP CODE:
95521
CAPACITY: 4CENSUS: 0DATE:
01/08/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Judi GiuntiniTIME COMPLETED:
05:40 PM
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At approximately 2:00PM, Licensing Program Analyst (LPA) Chris Arnhold met with Applicant Judi Giuntini, to conduct an announced pre-licensing inspection. LPA toured the facility bedrooms, common rooms, and grounds. Facility has a total of four bedrooms for residents. All doorways and walkways are unobstructed, and facility is clean and in good repair. The temperature in the main living area was 68.1 degrees F upon arrival. Hot water measured within acceptable range between 105-120 degrees F in kitchen and resident bathroom. There are books and games and space for resident activities. There is a locked closet containing toxins and cleaning supplies. LPA observed a good supply of back up linens and toiletries. Licensee has non-perishable food stores, but will not purchase perishable food items until they accept clients.

LPA observed fully charged fire extinguishers, operable smoke alarms and carbon monoxide detectors throughout the building. All appliances were in place and working. All required postings were posted in a hallway near the entrance to the facility.
Medications and records will be centrally stored in a locking closet.

LPA conducted a component III orientation with applicant, and the applicant has shown they have a good understanding of Title 22, and have appropriate knowledge to operate a residential facility.

LPA found this facility ready to be licensed. License will be granted after application has a final management review.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2024
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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