374603309-12-15-2023-08-AS-MGCO-CYJVPM-20231215153654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374603309
Report Date: 12/15/2023
Date Signed: 12/15/2023 03:37:08 PM

Document Has Been Signed on 12/15/2023 03:37 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:	BONITA RESIDENTIAL CARE		FACILITY NUMBER:	374603309
ADMINISTRATOR:	WA LAI BERNARTE		FACILITY TYPE:	735
ADDRESS:	4807 DEL PRADO STREET		TELEPHONE:	(619) 942-3642
CITY:	BONITA	STATE: CA	ZIP CODE:	91902
CAPACITY: 6		CENSUS: 6	DATE:	12/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Administrator, Wa Lai Bernarte		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified herself and was granted entry by Caregiver, Theresa Sy. Administrator, Wa Lai Bernarte, arrived later during the visit and LPA disclosed the purpose of the visit. According to the facility’s license, the facility is approved to serve six (6) developmentally disabled ambulatory clients. During today’s inspection, the facility had six (6) clients in care, all clients were out in the community, two (2) clients were attending day program and four clients (4) were working. All clients were ambulatory. The facility does not feature a secured perimeter or delayed egress doors. LPA Garcia-Centeno was accompanied by Caregiver, Sy while touring the interior and exterior of the facility. In addition, the clients’ rooms were inspected. The facility was clean and in good repair. Pathways were free of obstruction and slip hazards. The clients’ bedrooms contained the required furnishings. The doors, toilet, and shower were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s internal temperature, refrigerator, and freezer temperatures were within the regulatory range. During today’s visit, LPA observed, via measurement with a thermometer, that the hot water temperature from the kitchen faucet accessible to clients was within regulatory range. There were at least 2 days of perishable food, and at least 7 days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. (Continue at LIC809)

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

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 DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: BONITA RESIDENTIAL CARE	FACILITY NUMBER: 374603309
	VISIT DATE: 12/15/2023

NARRATIVE

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(Continue from LIC809)

There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required and stored in locked areas. Confidential client and staff records were appropriately stored. No pools or bodies of water were observed on the premises. Per the administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. The fire extinguisher was serviced within the last 12 months. Facility staff conducted a fire drill on September 7, 2023, and will be conducting another fire drill in December 2023. The first aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

LPA interviewed staff present during the visit and reviewed staff and client records. LPA interviews did not raise any licensing concerns. The client files that LPA reviewed contained the required documents. Staff records contained proof of current first aid training. The licensee presented proof of current/active business liability insurance and surety bond as required by Title 22 regulations.

No deficiencies were cited or observed on this date.

The Licensee was provided a copy of her appeal rights (LIC9058 01/16). An exit interview was conducted with Administrator, Bernarte, and a copy of this report was provided at the end of the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

LIC809 (FAS) - (06/04)

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