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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880996
Report Date: 08/25/2021
Date Signed: 08/25/2021 01:56:09 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:TAMARIND SENIOR CARE, LLCFACILITY NUMBER:
361880996
ADMINISTRATOR:RAMAS, SOTERO CHANDLER IIIFACILITY TYPE:
740
ADDRESS:9545 TAMARIND AVETELEPHONE:
(909) 346-0292
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY:6CENSUS: 4DATE:
08/25/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Sotero Chandler Ramas IIITIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Melody Brown conducted an unannounced visit to the facility for the purpose of completing a Health and Safety check. LPA Brown was greeted and granted entrance by caregiver Kevin Baas Ortiz and explained the purpose of today's visit. Caregiver Ortiz accompanied LPA on a tour of the inside and outside of the facility. Administrator Sotero Chandler Ramas III was contacted and arrived during the inspection. LPA Brown met with Administrator Sotero Chandler Ramas III and explained the purpose of the inspection.

Residents in care were present during visit. Residents in care appeared to be safe with no imminent health/safety concerns observed. LPA Brown observed no health/safety hazards inside the facility. LPA Brown inspected the outside perimeter of the facility and observed no health/safety hazards. There was sufficient number of staff present at the facility to provide care for residents. LPA Brown inspected facility food supplies and observed an adequate supply of perishable and non-perishable food. LPA Brown observed a screening area, proper signage throughout the facility, sufficient hand hygiene supplies, cleaning supplies, and a sufficient supply of Personal Protective Equipment (PPE). Sharps, cleaning supplies and medications were locked and inaccessible to residents. The needs of the residents in care appeared to be met during the inspection.

An exit interview was conducted where this report (LIC 809) was discussed and provided to Administrator Sotero Chandler Ramas III.

SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Melody BrownTELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
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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