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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603356
Report Date: 08/30/2024
Date Signed: 08/30/2024 01:47:46 PM


Document Has Been Signed on 08/30/2024 01:47 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 LODGE ASSISTED LIVINGFACILITY NUMBER:
374603356
ADMINISTRATOR:SERENA NELSONFACILITY TYPE:
740
ADDRESS:15855 MARMAC DRIVETELEPHONE:
(760) 440-0168
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY:6CENSUS: 4DATE:
08/30/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Caregiver Jamie WinterTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Ryan Fulton conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Caregiver Jamie Winter. The facility's license shows a maximum capacity of six (6) residents. During today’s inspection there were four (4) residents in care.

LPA and Caregiver Jamie Winter toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. clients’ bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all of which are safely stored. Cooking/dining equipment and utensils were present. Toxic chemicals/poisons were locked and inaccessible to residents. Medications were labeled, as required, and stored in locked areas. The facility’s ambient internal temperature was compliant. Hot water temperature at taps accessible to residents were all compliant: Kitchen sink was 113.6 F; bathroom #1 sink was 111 F and bathroom #2 sink was 113.6

Pools on the property was properly fenced with a fence that measured at least five feet and a security lock on the entrance to the pool . Per Caregiver Jamie, no firearms or ammunition are kept at the facility. Carbon monoxide/Smoke detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

No deficiencies were cited during the inspection. An exit interview was conducted with Caregiver Jamie Winter to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISOR'S NAME: Jennifer LottTELEPHONE: (619) -76-2311
LICENSING EVALUATOR NAME: Ryan FultonTELEPHONE: 619-629-8938
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2024
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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