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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004509
Report Date: 03/03/2025
Date Signed: 03/03/2025 10:15:52 AM

Document Has Been Signed on 03/03/2025 10:15 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:BONAFIDE HOME CAREFACILITY NUMBER:
306004509
ADMINISTRATOR/
DIRECTOR:		ERLEEN B. RINEHARTFACILITY TYPE:
740
ADDRESS:25215 ROMERA PL.TELEPHONE:
(949) 306-1521
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 6CENSUS: 5DATE:
03/03/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Arcely Santos- CaregiverTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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On March 3, 2025 at 8:50 am, Licensing Program Analysts (LPAs) Nancy Guillen and Ruth Martinez conducted an unannounced Plan of Correction Visit to follow up on Plan of Corrections (POC) cited on January 22, 2025. LPAs were greeted and granted entry by caregiver Arcely Santos and explained the reason for the visit. Caregiver called Administrator (AD) Erleen Rinehart over the phone and notified AD of our visit. AD was unable to join, but assisted over the phone.

LPAs observed the outside of the facility and reviewed staff files and made the following observations:

Deficiencies cited under Title 22 Regulation California Codes 87412(a) pertaining to staff files has been cleared. LPAs observed records for two out of two staff and it was observed with the required components; however a Technical Violation was cited on today's date for Administrators file.


Deficiencies cited under Title 22 Regulation California Codes 87307(d)(6) pertaining to outdoor obstructions has been cleared. LPAs observed the backyard was free of sharps and tripping hazards.


An exit interview was conducted and a copy of this report, LIC 311F, LIC 9102TV and two POC letters were left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Nancy Guillen
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2025
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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