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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364840450
Report Date: 03/03/2023
Date Signed: 03/03/2023 03:16:33 PM

Document Has Been Signed on 03/03/2023 03:16 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CASA RAMONA INCFACILITY NUMBER:
364840450
ADMINISTRATOR:TABITHA THURFACILITY TYPE:
850
ADDRESS:1633 W. 5TH STREETTELEPHONE:
(909) 889-0011
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92411
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 0DATE:
03/03/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:32 PM
MET WITH:Acting Director Yessenia ArguetaTIME COMPLETED:
03:30 PM
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On 03/03/2023 at 01:32PM, Licensing Program Analysts (LPAs) Perla Ordones and Laura Mejorado arrived at the facility to conduct a Case Management Plan of Correction (POC) Visit. LPAs met with and were granted entry by Acting Director Yessenia Argueta. LPAs explained that the purpose of today's visit was to ensure that the POCs related to the annual inspection that was conducted on 11/17/2022 were completed. LPAs took census, toured the facility, and observed the following corrections:

· Facility obtained batteries for carbon monoxide detector and are now in possession of two working carbon monoxide detectors
· Physician’s report was obtained for C2 has been obtained and added to C2’s file
· Proof of TB test for S1 in room A1 was obtained and has been added to S1’s file
· Facility has placed lids on waste bins which are used to store solid waste
on what corrections are seen]
During this visit, no children were present at the facility. LPAs took note of the lid used to cover the waste bin used to store solid waste and noticed that it was not tight fitting. LPAs discussed the matter with Acting Director who agreed to obtain a tight fitting lid for the waste bin. Acting Director also agreed to send proof of tight fitting lids when it has been obtained. Additionally, LPAs noticed that the outside playground closest to the facility entrance has loose and missing screws on the playground panels. Acting Director agreed to make the playground inaccessible to children and send proof to LPAs when the playground has been fixed. Acting Director stated the playground could be fixed by 03/10/2023.

LPAs also obtained a written statement from Acting Director Yessenia Argueta detailing how the facility will remain in contact with Community Care Licensing (CCL) when POC submissions are due and that the facility will submit POCs on time. Another written statement was obtained from Acting Director Yessenia Argueta stating that she agrees to submit all remaining director’s packet items by 03/10/2023.

Exit interview conducted with Acting Director Yessenia Argueta, Notice of Site visit was posted, and no deficiencies were cited.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Perla Ordones
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2023
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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