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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005390
Report Date: 03/07/2023
Date Signed: 03/07/2023 04:23:13 PM

Document Has Been Signed on 03/07/2023 04:23 PM - 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:RAMIREZ CARE HOMEFACILITY NUMBER:
347005390
ADMINISTRATOR:RAMIREZ, ROWENAFACILITY TYPE:
735
ADDRESS:10575 HOME RANCH COURTTELEPHONE:
(916) 638-2653
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY: 4CENSUS: 4DATE:
03/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Rowena RamirezTIME COMPLETED:
04:45 PM
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On 03/7/23 at 8:45am Licensing Program Analysts (LPAs) Kevin Gould and Tung Tuong arrived at Ramirez Care Home for the purpose of conducting a required 1 year annual inspection. LPA met with Licensee, Rowena Ramirez and together conducted a tour of the home.

LPA and licensee evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor and clean. LPAs observed a faucet handle that had come loose in a resident bedroom. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA advised the licensee to replace use non-slip bath mats in the bathroom instead of towels to prevent slipping.

LPA measured the water temperature, temperature measured at 117 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven-day non-perishable and two-day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents.

LPA Gould reviewed all resident files and observed to be complete and well organized. LPA reviewed two staff files and observed the files to be complete and well organized.

Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted, and a copy of this report was left at the facility.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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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