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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547209067
Report Date: 12/06/2021
Date Signed: 12/06/2021 03:21:36 PM

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:RONO GARDENSFACILITY NUMBER:
547209067
ADMINISTRATOR:FLORENTINO, MARKFACILITY TYPE:
740
ADDRESS:2547 N RONO STREETTELEPHONE:
(626) 278-8371
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:6CENSUS: 0DATE:
12/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Staff Staff Peggy MonclovaTIME COMPLETED:
01:30 PM
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Licensing Program Analyst LPA Shawna Doucette and Kamaldeep Kaur conducted an Annual Inspection on this date. LPA contacted Administrator Mark Florentino via phone and discussed the purpose of the visit. Staff Peggy Monclova responded to the facility to assist with the inspection. LPAs and Staff Peggy Monclova began the tour at the front entrance/office of the facility.

Facility has one entrance/exit point. Facility does not currently have clients in care or staff. Facility was recently licensed. Facility will submit photos of Covid signs/Handwashing signs throughout the facility. Facility will submit a photo of visitor/sign in station. Facility has a mitigation plan however will need to submit mitigation plan on LIC808.

Cleaning supplies were observed behind a locked in a closet.

No deficiencies were observed.

Exit interview was conducted and a copy of this report was provided
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 650-7923
LICENSING EVALUATOR NAME: Shawna DoucetteTELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021
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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