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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191591883
Report Date: 07/22/2022
Date Signed: 07/22/2022 11:16:56 AM


Document Has Been Signed on 07/22/2022 11:16 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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:TORY CARE HOMEFACILITY NUMBER:
191591883
ADMINISTRATOR:DANILO RAMOSFACILITY TYPE:
740
ADDRESS:2721 TORY ST.TELEPHONE:
(626) 965-4899
CITY:WEST COVINASTATE: CAZIP CODE:
91792
CAPACITY:5CENSUS: 4DATE:
07/22/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Danilo Ramos, LicenseeTIME COMPLETED:
11:20 AM
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An informal office meeting was held at the Monterey Park Adult and Senior Care Licensing Office. Licensing Program Manager (LPM) Lisa Hicks, and Licensing Program Analyst (LPA) Noemi Galarza met with Licensee/Administrator Danilo Ramos .The purpose of the meeting is to discuss resident population, care concerns, and staffing needs/schedules.

There currently are four (4) Level 3 residents over the age of 60 in placement by the San Gabriel/Pomona Regional Center; of which three (3) are developmentally disabled, and one (1) is a private pay resident. Licensee stated three (3) residents are ambulatory and one (1) is non-ambulatory/wheel chair bound. Zero residents (0) are in hospice, (0) bedridden, and (0) receiving home health.

Discussion:
  • Staffing needs and schedules were discussed. Licensee and wife reside in the home, and at this time have (2) additional staff work at the facility with alternate work schedules.

  • Complaint control #:28-AS-20200826134136 dated 8/26/2020 was addressed. The allegations allege neglect of medical care. Mr. Danilo Ramos stated the resident no longer resides at the facility, and does not know the resident's whereabouts as of this date. Licensee stated he does not remember the reason the resident was not taken to the doctor in a timely manner since it occurred a couple of years ago.
  • Licensee stated that he is considering relocating the private pay resident due to decline in mobility and increase care needs. Mr. Danilo Ramos requested advise and assistance with this matter.

Exit interview was conducted with Danilo Ramos. A copy of the report was provided.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi GalarzaTELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2022
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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