<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 286804119
Report Date: 01/15/2025
Date Signed: 01/15/2025 11:39:43 AM

Document Has Been Signed on 01/15/2025 11:39 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: 4DATE:
01/15/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Rowena RadanaTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
At approximately 11:15AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct a Plan of Correction (POC) visit. LPA met with House Manager Rowena Radana. On 12/30/2024, LPA made an unannounced visit and observed the Administrator was not and had not been present at the facility. LPA cited the violation and requested a written statement from Licensee and an updated LIC500, Personnel Summary. The documents were to be submitted by POC date of 01/06/2025. As of today's date, no documents have been received. A civil penalty of $100 per day, for nine (9) days is being issued.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Rowena Radana and Appeal rights were given.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE: DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/15/2025
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 1