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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206892
Report Date: 08/17/2023
Date Signed: 08/21/2023 11:09:14 AM

Document Has Been Signed on 08/21/2023 11:09 AM - 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:RHONEFACILITY NUMBER:
157206892
ADMINISTRATOR:CRANDELL, ROBERTFACILITY TYPE:
735
ADDRESS:7001 RHONE DRIVETELEPHONE:
(661) 396-0465
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 4CENSUS: 3DATE:
08/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Dina Fay, Administrator TIME COMPLETED:
04:30 PM
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On 08/17/23, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility. Administrator provided a tour of the facility inside and out.

LPA observed residents in care at the time of visit. Facility is a 4 bedroom 2 bathroom home. Residents bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards. Facility temperature was 83 degrees F.

Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 108 degrees F. Trash can with lid and hand washing postings were observed.

Medications were observed to be locked in a cabinet located in the kitchen. Cleaning supplies were observed to be locked under the garage kitchen sink. LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. There are no residents with Restricted Health conditions in the facility.

Carbon monoxide and smoke detectors were tested and observed to be operational. Fire Extinguisher was observed with a service date of 01/06/23. Internet devices and a working phone line were observed to be available for residents in care.

(Continued on LIC 809-C)

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: RHONE
FACILITY NUMBER: 157206892
VISIT DATE: 08/17/2023
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(Continued from 809)

The exterior tour of back yard was conducted and found to be free from debris. A covered outdoor seating area was observed for residents in care. Side gate was self-closing and self-latching.

A resident file were reviewed and observed to have update emergency contacts, Admission agreement, and current physician report/individual performance plans (IPP). A sample of staff files will be reviewed at a later date.

The following documents are requested and submitted to Fresno CCL by: 08/28/23:
LIC 308, LIC309 (If Applicable) LIC 400, LIC 402, LIC 500, LIC 610D, Copy of current Administrator certificate and Emergency and Disaster Plan.

An exit interview was conducted with Administrator. A copy of this report was discussed and will be provided via email. No deficiencies cited on today's visit.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC809 (FAS) - (06/04)
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