Ranch Country Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Ronald Dayo and was granted entry to the facility. At the time of the visit there was two (2) staff present, and four (4) residents present. The facility is a five (5) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, with an attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (4). LPA was accompanied by Facility caregiver, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. During inspection LPA observed facility main exterior door to have double lock LPA did no observe fire clearance or CCL approval to be in file. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. During room inspections LPA observed cameras to be in residents rooms. LPA observed one (1) out of (4) written consents to be in file. LPA will be issuing deficiency. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. LPA observed an in-ground pool in the backyard; the perimeter of pool is gated however, LPA observed that pool gate did not have a lock. LPA will be issuing deficiency. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside kitchen cabinets inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed four (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, facility has been issued two (2) deficiencies, cited per Title 22, division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Caregiver Ronald Dayo.the state’s words, verbatim · CDSS document, Oct 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Javier Prieto and LPA Eldin Serrano made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. Administrator Ramas welcomed LPA and was granted entry to the facility. The facility is a five (5) bedroom, 2 and a half (2 1/2), bathroom home and, with a kitchen/dining area, and living room. Licensed capacity is six (6) current census six (6). LPA was accompanied by MS. Ramos to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstand, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. All sharps are locked. There was a designated office for client/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed six (6) client files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. This report was signed by LPA Prieto, LPA Serrano and Administrator MS Ramos and this report was left with the facility.the state’s words, verbatim · CDSS document, Aug 13, 2024

Allegation investigated: Facility has pests.

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to initiate a complaint investigation regarding the above allegation. Regarding the allegation that the facility has pest: LPA toured the facility with staff (S1) Anita Tablit and found the facility to be clean, free of odors and free of insects or pest. LPA inspected kitchen, opended drawers, cupboards and refrigerator and did not observe any roaches at time of inspection. S1 interviewed and stated that there was no observations of any roaches on the kitchen. Staff (S2) Tita Mateo interviewed and stated that there was no onservation of roaches in the kitchen. LPA did observe a can of roach spray stored in drawer under the kitchen sink. LPA did not observe any live to dead roaches in the kitchen. ****Continued on LIC 9099 C**** Unsubstantiated LPA Prieto interviewed residents (R1, R2, R3, R4 and R5) and none were able to communicate if the facility has had a infestation of insects or pest. Administrator Melrose Ramos was unable to be communicated with at time of inspection. During today's inspection, LPA was not able to confirm that the facility has pest. Based on the information obtained there is not enough evidence that the facility has pest. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. This report was signed by staff Anita Tablit and LPA Prieto and a copy was left with the facility.the state’s words, verbatim · CDSS document, Dec 5, 2023 · control 56-AS-20231204101736

Type of visit: Case Management - Deficiencies

On this date of inspection, relating to complaint #56-AS-20231204101736, LPA Prieto toured the facility with staff Anita Tablit and observed two (2) deficiencies not related to the above complaint number. During inspection of facility kitchen, LPA Prieto did observe a can of roach spray stored in drawer under the kitchen sink that was not locked. Moreover, during time of inspection, LPA Prieto attempted to communicate with the facility Administrator Melrose Ramos, but was not available reach MS Ramos in person or by phone. No staff at the facility, during this inspection, were designated to represent the administrator during Ms Ramos absence. LPA Prieto informed staff Tablit that deficiencies will be issued as this poses potential health, and safety risk to residents in care. An exit interview was conducted where this report LIC809, LIC809D and Appeal Rights were discussed and provided to Ms Tablit.the state’s words, verbatim · CDSS document, Dec 5, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Dec 22, 2023

Administrator - Qualifications and Duties All facilities shall have a certified administrator with enough freedom from other responsibilities and a sufficient number of hours on the premises to give adequate attention to the administration of the facility. This requirement is not met as evidenced by: Administrator Melrose Ramos was not available during time of inspection and was not able to communicated with by phone.the state’s words, verbatim · CDSS document, Dec 5, 2023

Plan of correction: Administrator Ramos to submit documentation of designated administrator during her absence to be able address matters at her facility when she cannot attend during LPA visits, by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87705(f)(2) · Plan of correction due date: Dec 5, 2023

Care of Residents with Dementia The following shall be stored inaccessible to residents with dementia: toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement was not met has evidenced by: During time of facility kitchen inspection, LPA observed a can of roach spray, under the kitchen sink which was unlocked and accessible to clients.the state’s words, verbatim · CDSS document, Dec 5, 2023

Plan of correction: Staff removed toxin, during today's inspection, and placed in cabinet in the laundry room, which is locked and inaccessible to clients.