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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209417
Report Date: 04/15/2025
Date Signed: 04/15/2025 06:11:04 PM

Document Has Been Signed on 04/15/2025 06:11 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:REAL CARE LLCFACILITY NUMBER:
157209417
ADMINISTRATOR/
DIRECTOR:		PELAYA, JESSICAFACILITY TYPE:
740
ADDRESS:818 REAL RDTELEPHONE:
(661) 370-0090
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 300CENSUS: 0DATE:
04/15/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Benjermin Donel & Jessica PelayaTIME VISIT/
INSPECTION COMPLETED:
06:15 PM
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Licensing Program Analyst (LPA) Katie Brown arrived at the facility to conduct a Pre-Licensing Inspection. LPA met with Licensee Benjamin Donel and Administrator Jessica Pelaya. The facility has capacity for 300 residents. Per Fire Clearance, 290 Non-Ambulatory and 10 Bedridden. A hospice waiver has been granted for 10.

The Independent (IND) and Assisted Living (AL) residents will reside in a mixed setting. The Memory Care (MC) is a designated portion of the building. The facility has designated 67 rooms as AL, 36 rooms as IND and 32 as MC.

LPA began the tour by entering through the main entrance/lobby of the 2-story building. Required postings were observed and hung as required. Common areas throughout the facility were well lit with clear walkways. Furniture was observed to be properly spaced and in good condition. Flooring found to be intact throughout.

Resident apartments (IND, AL and MC) were randomly selected and toured. LPA observed operating AC/Heating units, Smoke/Carbon Monoxide detectors. Bathrooms were in good repair with faucets delivering hot water. The facility currently has apartments “move in ready” on the first floor AL and IND living. In these rooms contained, required furniture, furnishings and linens were observed. There is a signal system in place which was operational. Hot water in rooms toured measured between 107 – 114 degrees Fahrenheit. LPA observed supply of paper products, bed linens, towels and personal hygiene/grooming products.

The kitchen was observed to have both walk in and stand-alone freezers and refrigerators which were maintained at required temperatures. LPA observed supply of dishes, plates, utensils, and cooking items. Cleaning supplies and chemicals as well as knives and sharp items are properly stored. Appliances were found to be in working order. The kitchen was clean with floors and storage areas intact.
NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Katie Brown
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: REAL CARE LLC
FACILITY NUMBER: 157209417
VISIT DATE: 04/15/2025
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LPA observed medication rooms on first and second floors. The facility has three locking medication carts which will be utilized in medication pass throughout the facility. The First aid kits contained the required items. Emergency food and water supplies were observed. The Fire Extinguishers were serviced 6/24/2024 by Independent Fire & Safety. Doors and passageways are unobstructed throughout the inside of the facility common areas. The elevators were tested and in working order. A laundry room was observed with new appliances and room for storage.

Outside of the facility was toured. The grounds are well maintained with clear and defined walkways. There is a gated pool which was gated and locked as required.

The following requirements have not been met at the time of this inspection:
1. Toilet grab bars need to be installed in resident bathrooms
2. All apartments were not found to be useable during the visit
3. Carpets were soiled in some areas. Carpet cleaning was in process during the visit
4. Delayed Egress system was not operable and under repair during the visit

An exit interview was conducted with LIC and AD. It was explained that once the items above were complete and resolved, LIC will notify LPA Brown, and a subsequent inspection will be scheduled. The COMP III was not conducted during this visit. A copy of this report was signed and emailed to ben@sunsetequitygroup.com
NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Katie Brown
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025
LIC809 (FAS) - (06/04)
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