<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191500496
Report Date: 12/21/2023
Date Signed: 12/21/2023 10:17:25 AM


Document Has Been Signed on 12/21/2023 10:17 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:MOUNT SAN ANTONIO GARDENSFACILITY NUMBER:
191500496
ADMINISTRATOR:JOYCE FREMPONGFACILITY TYPE:
741
ADDRESS:900 EAST HARRISON AVENUETELEPHONE:
(909) 624-5061
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY:520CENSUS: 402DATE:
12/21/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Joyce Frempong, Patricia Williams, Ariana VillapuduaTIME COMPLETED:
10:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Elizabeth Irra conducted an announced visit to inspect the newly developed building located within this campus. The current census for Assisted Living is 76 and the census for independent living is 326 for a total of 402. LPA met with Patricia Williams (CEO), Will Levitt (VP of Facilities), Jason Gonzalez (Plant and Engineering Manager), Ariana Villapudua (Director of Admissions), Joyce Frempong (Director of Residential Health Services/RFCE Administrator), Tom Billings (KAR Construction), Larry Sisneros (AIA Architect) and Eric Entrekin (Project Superintendent).

LPA toured the building and inspected the following:
This building consists of (3) floors with a total of (53) independent living units. The Fire Department provided clearance for this building (known as Cedars Building/independent living) on 12/07/2023. Rooms inspected: 112 (Atlantica), 116 (Cypress), 202 (Cypress), 205(Juniper), 307(Deodar) and 312 (Atlantica).
  • All units consist of (1) or (2) bedrooms and/or (1) (1 and 1/2) or (2) bathrooms, living room, laundry room, kitchen, closet, storage space and balcony/patio.
  • All units include all electric appliances (stove, microwave, refrigerator, washer, dryer).
  • All units have their own thermostat to regulate their own room temperature.
  • All full-sized bathrooms have grab bars inside the showers.
  • All main bedrooms have a signal system for "daily check-ins" or assistance which is connected to the main campus server.
  • Fire extinguishers were observed in the hallways and were last serviced on 11/20/2023.

No deficiencies noted. Exit interview conducted and a copy of this report was provided to Joyce Frempong.
SUPERVISOR'S NAME: Tony VasalloTELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Elizabeth IrraTELEPHONE: (323) 981-3979
LICENSING EVALUATOR SIGNATURE:
DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/21/2023
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 1