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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208872
Report Date: 02/28/2022
Date Signed: 02/28/2022 03:06:26 PM

Document Has Been Signed on 02/28/2022 03:06 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:ROMERI SISTER HOMES LLCFACILITY NUMBER:
547208872
ADMINISTRATOR:TILTON, YVETTEFACILITY TYPE:
735
ADDRESS:1740 BEL AIRE AVETELEPHONE:
(559) 781-3613
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 6CENSUS: 4DATE:
02/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Tonie RomeriTIME COMPLETED:
03:10 PM
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LPA was met by Administrator, Tonie Romeri and stated the purpose of the visit. A tour of the facility was conducted. COVID-19 guidelines are in place. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point used by staff and all visitors.

Facility observed clean with no obstruction or fire clearance issues. Hand sanitizer was readily available throughout the facility for residents, staff and visitors. Resident bedrooms toured, resident bedrooms have a minimum of 6 feet between beds.

Fire extinguisher present and has a service date of 10/11/2021. Smoke detectors and carbon monoxide detectors present and observed operational during today's inspection.

LPA observed food supply adequate for the residents in care. Cleaning and PPE supplies were checked. Mitigation submitted to Department and is on file. Tonie Romeri serves as facility Administrator certification #6044260735, expires 4/18/2023.

Facility to submit updated LIC 500, LIC 610, and LIC 9020 to Fresno CCL office by 3/11/2022.

No deficiencies were observed during today's inspection. Exit interview was conducted. Administrator was informed that as a COVID-19 precautionary measure, this report will be emailed.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2022
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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