366426789-12-26-2023-56-AS-ACON-CYVVKV-20231226153057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 366426789
Report Date: 12/26/2023
Date Signed: 12/26/2023 03:31:12 PM

Document Has Been Signed on 12/26/2023 03:31 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	RAINBOW CARE		FACILITY NUMBER:	366426789
ADMINISTRATOR:	RACHEL PADILLA		FACILITY TYPE:	735
ADDRESS:	2853 W. SUMMERSET DRIVE		TELEPHONE:	(909) 835-8046
CITY:	RIALTO	STATE: CA	ZIP CODE:	92377
CAPACITY: 6		CENSUS: 2	DATE:	12/26/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Rachel Padilla, Administrator		TIME COMPLETED:	03:30 PM

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Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Rainbow Care, Adult Residential Facility unannounced to conduct an Annual Inspection. LPA was greeted and granted entry by Administrator, Rachel Padilla. LPA introduced self and stated purpose of the visit. LPA was provided a space to work inside the staff office and accompanied on a walk through of the facility's interior and exterior. At the time of the visit there were 2 residents in care, while another 2 residents were out of the facility.

The facility is an Adult Residential Facility (ARF). The facility is licensed and approved for six, (6) residents with 4 residents in care at this time. The facility maintains partnership with the Inland Regional Center, (IRC) at a Level 2. LPA was accompanied by Facility Administrator, Rachel Padilla to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). Pathways to the facility were clear of clutter/obstructions. The facility was maintained at a comfortable temperature.

LPA observed resident bedrooms; each was personable and equipped with all required furniture such as: mattresses with adequate linens, night stand and sufficient storage and lighting. LPA inspected 2 bathrooms and observed that each were clean and orderly with operational and appliances. LPA observed night lights and lamps throughout the facility to provide adequate lighting. LPA observed sufficient seating and furniture in the facility's dining room, living room and den areas. LPA found that hot water is deliverable in the facility. Water temperature tested within regulation. The facility is equipped with operable smoke/fire detectors and carbon monoxide alarms. Fire extinguishers, (2) found throughout the facility were last inspected April 2023.

LPA observed postings throughout the facility in prominent places. Postings such as personal rights, resident rights, Community Care Licensing Complaint, Long Term Care Ombudsman and the disaster/evacuation plan.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:	DATE: 12/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023

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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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: RAINBOW CARE	FACILITY NUMBER: 366426789
	VISIT DATE: 12/26/2023

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Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care.

Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly.

Based on observations, no deficiencies will be cited per Title 22, California Code of Regulations. A copy of this report was read/reviewed with Licensee; signature acknowledges understanding and receipt of report and attachments.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:	DATE: 12/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023

LIC809 (FAS) - (06/04)

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