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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701089
Report Date: 01/13/2022
Date Signed: 01/13/2022 12:44:55 PM

Document Has Been Signed on 01/13/2022 12:44 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:TOMORROW'S HOME, LLCFACILITY NUMBER:
392701089
ADMINISTRATOR:MORROW, ANGELIQUEFACILITY TYPE:
740
ADDRESS:965 LYNN COURTTELEPHONE:
(209) 595-6352
CITY:RIPONSTATE: CAZIP CODE:
95366
CAPACITY: 6CENSUS: 2DATE:
01/13/2022
TYPE OF VISIT:Post LicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Angelique MorrowTIME COMPLETED:
01:00 PM
NARRATIVE
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On 1/13/22 LPA M. Jensen and T. White arrived unannounced to conduct a required post-licensing inspection. LPA met with Administrator, Angelique Morrow and explained the purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 6 residents, which 6 may be non-ambulatory and 6 on hospice.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, laundry room, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 71 degrees Fahrenheit. The water temperature was measured at 105.1 which is within the required range of 105-120. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Furniture was observed to be adequate and in good repair. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods.
Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was purchased new in July of 2021. First aid kit was observed to be complete. Fire drill was last conducted on 12/7/2021. LPA observed completed mitigation plan. LPA reviewed 1 resident file and 2 staff file.

- LPA observed staff #1 (S1) not wearing a mask. Based on interview with administrator and S1 masks are not enforced.
- LPA observed outside shed with landscaping equipment including chainsaw unlocked
-LPA observed front porch patio in disrepair
-LPA observed medicine cabinet unlocked and accessible to residents
-LPA observed garage where cleaning supplies are stored to be accessible to residents.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties.

Exit interview conducted with Administrator. A copy of report and Appeal Rights given.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
Document Has Been Signed on 01/13/2022 12:44 PM - It Cannot Be Edited


Created By: Maja Jensen On 01/13/2022 at 12:23 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: TOMORROW'S HOME, LLC
FACILITY NUMBER: 392701089

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87468.1(a)(2)
Personal Rights of Residents in all Facilities
(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above in 87468.1 (a)(2). LPA observed Staff #1 did not wearing mask during insoection,which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/14/2022
Plan of Correction
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Administrator agreed to conduct in-service training regarding mask requirements and submit proof to CCLD by POC date.
Type A
Section Cited
CCR
87309(a)
Storage Space
(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 87309(a). LPAs observed unlocked shed, medications, and cleaning supplies which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/14/2022
Plan of Correction
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Administrator agreed to obtain a lock for shed, upgrade garage lock, and lock medication cabinet. Administrator agreed to submit proof to CCLD by POC date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Liza King
LICENSING EVALUATOR NAME:Maja Jensen
LICENSING EVALUATOR SIGNATURE:
DATE: 01/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/13/2022


LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 01/13/2022 12:44 PM - It Cannot Be Edited


Created By: Maja Jensen On 01/13/2022 at 12:23 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: TOMORROW'S HOME, LLC
FACILITY NUMBER: 392701089

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87307(d)(2)
Personal Accommodations and Services
(2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 87307(d)(2). LPAs observed patio in disrepair, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/28/2022
Plan of Correction
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Administrator agreed to repair front porch patio and submit proof to CCLD by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Liza King
LICENSING EVALUATOR NAME:Maja Jensen
LICENSING EVALUATOR SIGNATURE:
DATE: 01/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/13/2022


LIC809 (FAS) - (06/04)
Page: 3 of 5