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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 286804119
Report Date: 11/08/2024
Date Signed: 02/14/2025 09:02:44 AM

Document Has Been Signed on 02/14/2025 09:02 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:RAMEILS SACRED CARE HOMES 2FACILITY NUMBER:
286804119
ADMINISTRATOR/
DIRECTOR:		JEFFERSON, JENEROFACILITY TYPE:
735
ADDRESS:1513 RIO GRANDETELEPHONE:
(310) 531-6049
CITY:AMERICAN CANYONSTATE: CAZIP CODE:
95403
CAPACITY: 6CENSUS: DATE:
11/08/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Jenero JeffersonTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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Regional Manager, Carla Nuti-Martinez, Licensing Program Manager Victoria Bertozzi, Licensing Program Analyst Chris Arnhold and representatives from North Bay Regional Center met with Licensee, Jenero Jefferson to conduct a Non-Compliance Conference.

Parties discussed multiple areas of concern including but not limited to the following:
· Licensee did not comply with a recent audit conducted by the Department
· Licensee did not notify licensing that all properties are in foreclosure.
· Licensee is having financial issues that have resulted in the regional center paying taxes that are the responsibility of the Licensee and staff have received delays in receiving their paychecks.
Licensee to ensure the following:
· Licensee to ensure all documents that were requested by the CCL auditor to be sent to CCL no later than Tuesday, November 12, 2024
· Licensee to provide a written statement outlining the current status of the foreclosure and what their plan is in the event that the facility is not able to maintain control of property no later than Tuesday, November 12, 2024.
· Licensee to review H&S code 1562.2 for ARF homes and 1569.686 for RCFE home and follow through with reporting requirements listed. Licensee to submit copies of required notifications and self-certification of compliance no later than Tuesday, November 12, 2024.
Licensee agrees to be placed on a non-compliance plan for a period of two years.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Licensee. Failure to correct the deficiencies and/or repeat deficiencies within a 12-month period may result in civil penalties. Failure to correct the cited deficiencies, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

The Departments Technical support will continue to provide support during the agreed upon timeline.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
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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Document Has Been Signed on 02/14/2025 09:02 AM - It Cannot Be Edited


Created By: Christopher Arnhold On 11/08/2024 at 11:00 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: RAMEILS SACRED CARE HOMES 2
FACILITY NUMBER: 286804119

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/12/2024
Section Cited
HSC
1562.2(b)(1)

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(b) Licensee of an ARF shall inform the city & county in which the facility is located, the department, all residents, and, if applicable, their legal representatives, in writing, within 2 business days…of any of the following events, or knowledge of the event: (1) A notice of default, notice of trustee’s sale,
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Licensee to provide a written statement outlining the current status of the foreclosure and what their plan is in the event that the facility is not able to maintain control of property no later than POC due date 11/12/2024.
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or any other indication of foreclosure is issued on the property. Requirement is not met as evidenced by: Based on record review the licensee did not comply with the section cited above by not ensuring that CCL was notified when homes went into foreclosure which poses a potential health, safety or personal rights risk.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Bethany Moellers
LICENSING EVALUATOR NAME:Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
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