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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700810
Report Date: 04/28/2020
Date Signed: 04/28/2020 04:39:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:RADIANT LIVING SENIOR CAREFACILITY NUMBER:
312700810
ADMINISTRATOR:ONG, JONABELFACILITY TYPE:
740
ADDRESS:3108 RADIANT WAYTELEPHONE:
(916) 308-0698
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:6CENSUS: 0DATE:
04/28/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Jonabel OngTIME COMPLETED:
04:15 PM
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On 4/3/20, Licensing Program Analyst (LPA) Kevin Mknelly conducted a tele-visit with licensee Jobabel, who assisted in conducting this inspection.
LPA toured, with the assistance of Jonabel by video phone, Physical Plant, Food Service, Common Areas, Bedrooms, Bathrooms, Kitchen and Medication Storage. Fire (1) extinguishers is current (by receipt) and First Aid fully stock. Emergency/ Disaster plan is current.
Kitchen was clean and good repair. Facility does not have (7) seven (2) two day supply of non-perishable and perishable foods, and required emergency shelter in place supplies due to no clients in care and are knowledgeable of the requirement. Rooms inspected have appropriate items and are in good repair. Water temperatures was reported to be maintained between the required 105-120 degrees.
LPA observed locked centrally stored medications cabinet in the kitchen and toxins are to kept locked and inaccessible to residents, in a cabinet in the kitchen (other locations are yet to be determined). There are currently no staff or client files available for review.
Facility may accept total capacity of 6 non-ambulatory senior residents, one of which may be bedridden. All common areas appear to be free from hazards, clean and in good repair.
As of this date, the Department has received the fire clearance. During this visit, this facility is in substantial compliance and meets the minimum requirements for a RCFE license.

Component III was completed.
Licensee unable to sign. LPA sent a copy of report for Licensee to sign. Licensee to send a signed copy back to CCL.
Application is pending further review
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2020
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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