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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880991
Report Date: 11/09/2022
Date Signed: 11/09/2022 11:54:17 AM


Document Has Been Signed on 11/09/2022 11:54 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:BEST CARE GUEST HOMEFACILITY NUMBER:
361880991
ADMINISTRATOR:GARCIA, RICHIEFACILITY TYPE:
740
ADDRESS:817 S OAKS AVENUETELEPHONE:
(909) 638-8871
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY:14CENSUS: 10DATE:
11/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Administrator - Richie GarciaTIME COMPLETED:
12:05 PM
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Licensing Program Analysts (LPA) Victoria Chitgian and Licensing Program Manager (LPM) Efren Malagon made an unannounced visit to the facility. The purpose of the visit was to conduct a required annual inspection, with an emphasis on infection control due to the COVID-19 pandemic.

LPA met with Administrator Richie Garcia and was granted entry to the facility. At the time of the visit there was one (1) staff, and three (3) residents present.

LPA discussed COVID-19 best practices for infection control and prevention and toured the facility inside and outside with the Administrator. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolating residents and caring for residents with COVID-19 positive results and/or exposures. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, cleaning and disinfection provisions are in adequate quantities, and that staff are trained in the proper use and disposal of PPE.

The entrance of the facility has a check in process for staff and visitors that includes a temperature and symptom check. The bathrooms were stocked with hand soap and paper towels. Postings are seen throughout the facility for proper cough etiquette, proper hand washing procedure, and social distancing guidelines. LPA requested to inspect the facility's Personal Protective Equipment (PPE) supplies, which were in the Medication room. The facility has a full thirty (30) day supply of PPE items including gloves, face shields, gowns, disinfectant, surgical masks, N95 masks, and hand sanitizer available.

All staff and residents are practicing all other COVID-19 precautions, which minimize the risk of them contracting COVID-19. LPA and LPM toured the facilities interior and exterior and there were no health and safety concerns.
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Victoria ChitgianTELEPHONE: (951) 248-0306
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2022
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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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: BEST CARE GUEST HOME
FACILITY NUMBER: 361880991
VISIT DATE: 11/09/2022
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Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Richie Garcia
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Victoria ChitgianTELEPHONE: (951) 248-0306
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC809 (FAS) - (06/04)
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