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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593145
Report Date: 03/30/2023
Date Signed: 03/30/2023 12:10:28 PM

Document Has Been Signed on 03/30/2023 12:10 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, 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: 23DATE:
03/30/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:Licensee Stanley Kaniel TIME COMPLETED:
12:30 PM
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On 3/30/2023 at 9:05 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced Case Management visit to ensure the Licensee is in compliance with Title 22 regulations, and to follow up on physical plant deficiencies observed on 3/16/2023. The purpose of the visit was explained to Licensee Stanley Kaniel and tour of the facility was conducted.

During the visit dated 3/16/2023, LPA observed the hot water temperature measured at 124.5 in room #7, 123.0 in room #14, and in room #13 the hot water faucet is not operational.

During today’s visit, LPA received a copy of an SIR dated 3/28/2023 and discussed closure plans with Licensee Stanley Kaniel. Licensee Stanley Kaniel stated on 3/16/2023, that they would like to submit a change of ownership or sell the property. The licensee will submit a closure plan to LPA, by April 10th, 2023.


Report Continued on 809C
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Jewel Baptiste
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 - BELLFLOWER
FACILITY NUMBER: 191593145
VISIT DATE: 03/30/2023
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During today's visit, LPA observed the following updates
Building #1
· Bedroom #1
1. Currently being painted and remodeled
2. Has a new dresser
3. Has a new mattress
· Bathroom #1
1. Has a new sink and toilet
2. Has a new shower curtain
· Bedroom #3
1. Has a new light
2. 1 bed will be replaced today 3/30/2023
Building #2
· Bedroom #5
1. Has blinds
2. Heater was removed
Building #3
· Has a repaired fire panel
· Room #7-bathroom water temperature measured at 109.5
· Room #14- bathroom water temperature measured at 107.4
· Room # 14 hospital bed has been removed and the socket has been repaired
· There were no major changes in building #3

Exit Interview Conducted with Licensee Stanley Kaniel / A Copy of the Report Issued.



SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Jewel Baptiste
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC809 (FAS) - (06/04)
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