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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593145
Report Date: 01/05/2022
Date Signed: 01/05/2022 10:45:06 AM

Document Has Been Signed on 01/05/2022 10:45 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:RAMONA GUEST HOME - BELLFLOWERFACILITY NUMBER:
191593145
ADMINISTRATOR:KANIEL, STANLEYFACILITY TYPE:
735
ADDRESS:9555 RAMONA STTELEPHONE:
(562) 867-1002
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 29CENSUS: 26DATE:
01/05/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Stanley Kaniel - LicenseeTIME COMPLETED:
11:10 AM
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) Mary Flores conducted a case management visit during a complaint investigation visit on 1/5/22 due to COVID guidelines observations.

LPA Flores observed the following:

No point of entry for screening process.
No screening log with temperature log and screening questions available.
Additional signs must be posted throughout the facility


Facility is currently not following Mitigation Plan LIC 808 and COVID 19 recommendations and State, County guidelines. LPA Flores provided Technical Assistance and advice licensee that if facility continues to fail to follow recommendations deficiencies will be provided.

No deficiencies were given during this visit. However Technical Violation was given.

Exit interview was conducted with Stanley Kaniel Licensee and a copy of this report was provided.
SUPERVISORS NAME: Rebecca Orendain
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE: DATE: 01/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/05/2022
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