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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191591749
Report Date: 01/16/2025
Date Signed: 01/16/2025 03:21:37 PM

Document Has Been Signed on 01/16/2025 03:21 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CASA DE ESPERANZAFACILITY NUMBER:
191591749
ADMINISTRATOR/
DIRECTOR:
DENISE WHITEFACILITY TYPE:
735
ADDRESS:12000 DENHOLM DR.TELEPHONE:
(626) 444-8943
CITY:EL MONTESTATE: CAZIP CODE:
91733
CAPACITY: 15TOTAL ENROLLED CHILDREN: 0CENSUS: 15DATE:
01/16/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Denise Hornal, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analysts (LPAs) Mayra Cota and Luis De Leon and Licensing Program Manager (LPM) Adeline Ho made an unannounced case management visit regarding a self-reported incident on the relocation of one (1) client from Bedell Family Circle #191200012 (Woodland Hills, South Regional Office) to Casa De Esperanza #191591749 (12000 Denholm Drive, El Monte, CA 91733; Monterey Park Regional Office) due to mandatory evacuation orders from Fire Advisory. LPAs met with Denise Hornal, Administrator and explained the purpose of the visit. A physical plant tour of the facility was conducted to check the health and safety of the one (1) evacuee client.

The following observations were made:

· Relocated client (C1) is ambulatory, has a designated room with a bed, bedding linen and access to the bathrooms in the male wing. Towels and other personal items like clothing and shoes were observed in closet space accorded to C1 in the bedroom being used.
· Sufficient hygiene and toileting items were observed.
· Staff are handling/administering C1s medication and documenting on MAR log accordingly.
· At time of visit, three (3) Direct Support Staff were present to provide care for all clients. Review of staff rosters indicate there is sufficient staffing available to provide care for clients in the facility.
· Relevant documents for C1 were reviewed.
· The facility has sufficient 2-day perishable and 7-day nonperishable food supplies. The facility dining room can accommodate all clients.
· The last routine fire inspection was conducted June 9, 2024. The last fire drill was conducted on 12/5/24.
· Administrator stated that client’s responsible parties and families were notified of relocation via phone calls, email, and texts.
· Administrator stated transportation will be provided to take client to doctor appointments and other community functions.
· LPAs interviewed C1 and C1 stated, they have everything they need, and they are glad to be here.

Exit interview was conducted with Denise Hornal, Administrator and a copy of the report was issued.
Wei Siew HoTELEPHONE: (323) 981-3969
Mayra CotaTELEPHONE: (323) 980-4934
DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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