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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593145
Report Date: 05/12/2023
Date Signed: 05/12/2023 01:47:25 PM

Document Has Been Signed on 05/12/2023 01:47 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: DATE:
05/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:36 PM
MET WITH:Licensee Stanley KanielTIME COMPLETED:
02:15 PM
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On 5/12/2023 at 12:36 p.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. The purpose of the visit was explained to Licensee Stanley Kaniel and tour of the facility was conducted.

During the visit LPA followed up on Administrator Certificate. According to the Licensee, Monday (5/15/2023) the 40 hours to renew the facility’s administrator certification will be completed.

Licensee Stanley Kaniel stated the facility received two offers from potential buyers. A facility tour will be conducted with a potential buyer today (5/12/2023). LPA discussed the closure plan with the Licensee, which was due 4/10/2023 and 5/11/2023. The Licensee asked for an extension to finish the closure plan. The plan will be submitted on 5/22/2023 via fax.

The following updates since LPA’s last visit was observed during the tour:

Kitchen, TV room, and Dining room


· Floor tiles was replaced.

Building#1
· Bathroom#2- shower/tub was re-glazed

Report continued on 809c
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Jewel Baptiste
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2023
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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: RAMONA GUEST HOME - BELLFLOWER
FACILITY NUMBER: 191593145
VISIT DATE: 05/12/2023
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 Building#2
· No changes since the last visit

Building #3
· Bedroom#9- Hole in the ceiling was covered and will be painted over on Monday.
· Bedroom #11-floor tiles were replaced.
· Bedroom #12-floor tiles were replaced.
· Bathroom # 11&12- has new floor tiles
· Bathroom #13- Light fixtures was repaired and painted

Exit interview conducted with Licensee Stanley Kaniel and a copy of this report was provided.

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

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC809 (FAS) - (06/04)
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