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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336423931
Report Date: 07/24/2024
Date Signed: 07/24/2024 10:50:49 AM

Document Has Been Signed on 07/24/2024 10:50 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:LMC HOME CAREFACILITY NUMBER:
336423931
ADMINISTRATOR/
DIRECTOR:
REED, JR. WILLIAMFACILITY TYPE:
735
ADDRESS:3662 CYPRESS STREETTELEPHONE:
(951) 797-3860
CITY:BANNINGSTATE: CAZIP CODE:
92220
CAPACITY: 6CENSUS: 3DATE:
07/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:William Reed - AdministratorTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced annual inspection of facility. LPA met with William Reed, Administrator, and discussed the purpose of the visit. During the inspection visit, clients were attending Day program. LPA conducted an inspection of the facility, which included, but was not limited to, the following:

Operation/Physical Plant: The facility has a current census of three (3) clients. The facility’s indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor activity space for clients in care. The facility’s outdoor activity area is fenced with a self-latching gate. The facility is equipped with operating carbon monoxide alarms and telephone service. Client bedrooms were equipped with beds, bed linen, chairs, storage space and sufficient lighting. Client bathroom equipment were operating in safe and sanitary conditions. The hot water in client bathrooms tested at 105 degrees F. The facility has posted in a common area: Community Care Licensing Complaint poster, emergency telephone numbers, evacuation sketch, House Rules, and client personal rights.

Food Service: The kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food for number of clients in care. The facility’s freezer temperature is maintained at zero degrees. The facility’s refrigerator was maintained at 41 degrees F. The facility has sufficient cups, plates, and utensils for client use. Sharps, disinfectants and cleaning solutions are kept locked and store away from food areas.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE: DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: LMC HOME CARE
FACILITY NUMBER: 336423931
VISIT DATE: 07/24/2024
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Health Related Services: All client medications are labeled, centrally stored and kept locked. The facility has a first aid manual and first aid kit.

Personnel/Client Records: Staff records had health screenings, criminal record clearances, and first aid/CPR training certifications. Client records had admission’s agreements, medical assessments, needs and service plans, Personal and Incidental logs (P&I). Client and staff registry was centrally stored. The Administrator's certification is current. The facility has an emergency and disaster plan on file. The facility's last fire drill was conducted on 6/23/24.

No deficiencies were cited during today’s visit. An exit interview was conducted, where this report was discussed and a copy was provided to the Administrator at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024
LIC809 (FAS) - (06/04)
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