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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 365530001
Report Date: 07/15/2022
Date Signed: 07/15/2022 09:32:59 AM

Document Has Been Signed on 07/15/2022 09:32 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:BEBING HOME CAREFACILITY NUMBER:
365530001
ADMINISTRATOR:ZAPANTA, MAX M.FACILITY TYPE:
740
ADDRESS:17446 MADRONE STREETTELEPHONE:
(909) 574-6832
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 6CENSUS: 5DATE:
07/15/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator/Applicant Max ZapantaTIME COMPLETED:
09:45 AM
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Licensing Program Analyst (LPA) Melody Brown conducted an announced prelicensing visit this date, 07/15/2022 at 09:00 AM. This is an announced Pre-Licensing visit conducted with applicant/Administrator Max Zapanta who assisted in the tour of inside and outside of facility and the evaluation. LPA Melody Brown made a second (2nd) announced prelicensing visit this date. The follow up visit was made to confirm that all corrections have been made.

The following deficiencies: “(1) Obtain and post a Let-Us-No poster, (2) Remove tons of used clothes, recyclable, multiple large bins on outdoor pathways, (3) Obtain First Aid Book/Manual, (4) Post Visitor Policy Procedure and Visitor Policy Door Signs, (5) Covid-19 Symptoms Questions Logs, 6) Visitor Vaccination Verification Log .” All were found to be corrected on this visit date, 07/15/2022.

The facility was evaluated in accordance with the California Code of Regulations (CCR), Title 22, Division 6, Chapters 8 to ensure the health and safety of residents in care. Based on the observations and evaluation of the facility this date, the facility’s ready for licensure.

Applicant/Administrator Max Zapanta will be notified once facility is licensed.

An exit interview was conducted, and a copy of this report was left with applicant/Administrator Max Zapanta
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2022
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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