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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197801209
Report Date: 04/09/2024
Date Signed: 04/10/2024 10:42:25 AM

Document Has Been Signed on 04/10/2024 10:42 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:RNJ HOMES, INCFACILITY NUMBER:
197801209
ADMINISTRATOR/
DIRECTOR:
RECLUSADO, MARILOU F.FACILITY TYPE:
735
ADDRESS:18620 ELAINE AVENUETELEPHONE:
(562) 865-0834
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY: 4CENSUS: 4DATE:
04/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:22 AM
MET WITH:Robert CarmonaTIME VISIT/
INSPECTION COMPLETED:
02:30 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 Robert Carmona and explained the purpose for todays visit. The facility phone number is 562 865 0834.

The facility consist of four resident bedrooms, one staff bedroom, two bathrooms, a living room, family room, dining room, kitchen, laundry room, back yard(patio with tables and chairs), and a detached garage(storage). There are two additional rooms located upstairs that are designated for the licensee's(clients do not enter the second story).

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 114 degrees F. The last fire drill was conducted on 04/01/24.

There were no deficiencies cited.

Exit interview conducted.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Nicol Wesley
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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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