374603182-3-14-2025-08-AS-DRON-DERU59-20250314151624

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374603182
Report Date: 03/14/2025
Date Signed: 03/14/2025 03:17:50 PM

Document Has Been Signed on 03/14/2025 03:17 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 DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	RAMONA SENIOR MANOR		FACILITY NUMBER:	374603182
ADMINISTRATOR/ DIRECTOR:	GALANG, MARJORIE C.		FACILITY TYPE:	740
ADDRESS:	1236 D STREET		TELEPHONE:	(760) 440-9844
CITY:	RAMONA	STATE: CA	ZIP CODE:	92065
CAPACITY: 28	TOTAL ENROLLED CHILDREN: 0	CENSUS: 20	DATE:	03/14/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:30 AM
MET WITH:	Administrator, Isela Vega		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

NARRATIVE

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Licensing Program Analyst (LPA) David Roman conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA D. Roman entered the facility and identified himself to, Administrator, Isela Vega. LPA D. Roman discussed the purpose of the visit with the Administrator. According to the facility’s license, the facility has a maximum capacity of twenty eight (28) clients, of whom all may be non-ambulatory and nine (9) of whom may be bedridden on the first floor only.

LPA D. Roman along with Administrator toured the interior and exterior of the facility and inspected each room. The facility was sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. On the 1st floor the facility had sufficient space and equipment to facilitate dining, visitation, meetings, and resident activities. Laundry equipment is found on both floors.

LPA D. Roman along with Administrator, Isela Vega, entered the kitchen area, reviewed non-perishable foods for expiration dates, observed all refrigerators in working conditions and with plenty of food. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked room. Water temperature was measured at 115 degrees F. Two (2) exit doorways were tested for signal system. Administrator reported to have the auditory signal systems replaced due to malfunction.

No pools or bodies of water on the premises. LPA inquired if firearms or ammunition are kept in the facility, Administrator reported, no. On 02/07/25 fire system and carbon monoxide detectors were tested by 3rd party vendor. Emergency lighting and facility telephone were all working. Fire extinguisher(s) were present and serviced. First aid kit(s) were complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed had required documentation.

An exit interview was conducted with Administrator, Isela Vega, to whom a copy of this report and the Licensee/Appeal Rights were provided during the visit. Their signature confirms the receipt of the report and their rights.

Lizzette Tellez	TELEPHONE: (619) 767-2351
David Roman	TELEPHONE: 619-675-6197
	DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

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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Document Has Been Signed on 03/14/2025 03:17 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: RAMONA SENIOR MANOR	FACILITY NUMBER: 374603182
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

CCR

87705(d)

This requirement is not met as evidenced by: Care of Persons with Dementia The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions.
	Deficient Practice Statement
1 2 3 4	Based on LPA's observation of (2) two doorway exits, the licensee did not comply with the section cited above in two (2) out of (2) doorway exits which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/28/2025
	Plan of Correction
1 2 3 4	Administrator reported to have Maintenance Staff replace the auditory signal door systems and provide proof to LPA before POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Lizzette Tellez	TELEPHONE: (619) 767-2351
David Roman	TELEPHONE: 619-675-6197
	DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

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