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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197801041
Report Date: 02/15/2024
Date Signed: 03/07/2024 05:19:33 PM


Document Has Been Signed on 03/07/2024 05:19 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:RNJ HOMES INCFACILITY NUMBER:
197801041
ADMINISTRATOR:ROBERTO CAMANOFACILITY TYPE:
740
ADDRESS:11416 TINA ST.TELEPHONE:
(562) 864-2078
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:4CENSUS: 3DATE:
02/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Roberto CamanoTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced Required 1 year inspection at the facility and met with Administrator Roberto Camano and explained the purpose for todays visit. The facility phone number is 562 484 3823.

The facility consist of 4 bedrooms, 2 bathrooms, living room, dining room, kitchen, laundry area, garage for storage, and an shaded area,

LPA Wesley conducted a complete tour of the facility, and observe the supply of food. Resident medications, and medication logs were reviewed. The smoke detectors/carbon monoxide detector are operable. LPA observed one fire extinguisher in the kitchen. The water temperature was tested and measured 105 degrees F. LPA Wesley received a copy of the facility infection control plan at the time of visit.

Administrators certificate for #6008185740, Roberto Camano expires on 08/05/24.

There were no deficiencies cited.

Exit interview conducted.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Nicol WesleyTELEPHONE: (323) 981-3975
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2024
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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