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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600341
Report Date: 03/22/2024
Date Signed: 04/12/2024 09:12:46 AM


Document Has Been Signed on 04/12/2024 09:12 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245



FACILITY NAME:HUNTINGTON RETIREMENT HOTELFACILITY NUMBER:
191600341
ADMINISTRATOR:HEATHER ARGUETAFACILITY TYPE:
740
ADDRESS:20920 EARL STREETTELEPHONE:
(310) 370-5828
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY:155CENSUS: 100DATE:
03/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:ADMINISTRATOR HEATHER ARGUETATIME COMPLETED:
03:30 PM
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On 03/22/2024 at 9:00 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at Huntington Retirement Hotel Facility. LPA Jose Calderon was allowed entry into the facility by Administrator Heather Argueta. The facility is licensed for 155 residents aged 60 and over. Currently, there are (100) residents residing in the facility 60 years or older.

LPA Jose Calderon explained to Administrator Heather Argueta the purpose of the 1-year Annual Inspection visit, and escorted LPA Jose Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Jose Calderon reviewed: Ten (10) resident service records, ten (10) resident medication records, and LPA Jose Calderon interviewed ten (10) residents and six (6) staff members for a visit. LPA Jose Calderon inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 03/13/2024. The two-story commercial building consists of ninety-seven (97) resident bedrooms, ninety-seven (97) resident bathrooms, five (5) common bathrooms, dining room, commercial kitchen, staff room, office area, library, Media room, Garden area, washer and dryer/ storage area, backyard with umbrella with table and chairs. No weapons are stored on the premises. The Commercial Kitchen was inspected and observed to be clean and operational. A 2-day supply perishable and 7-day supply of non-perishable foods are present in the facility kitchen. Emergency Water Storage is in found inside the kitchen area.
SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Jose CalderonTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: HUNTINGTON RETIREMENT HOTEL
FACILITY NUMBER: 191600341
VISIT DATE: 03/22/2024
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LPA Jose Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Jose Calderon observed the following during inspection of resident’s rooms #108, #111, #112, #123, #133, #138, #141, #201, #222, #225: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Jose Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Jose Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 113 degrees Fahrenheit, and bathroom #2 hot water temperature properly measured at 111 degrees Fahrenheit, and Bathroom #3 hot water temperature properly measured at 110 degrees Fahrenheit. Commercial kitchen hot water temperature properly measured at 118 degrees Fahrenheit. Facility sixty (60) Carbon Monoxide and one hundred twenty (120) Smoke Detectors hard wired and connected were tested and are working properly. The facility twenty (20) Fire Extinguishers were checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knives are locked/secured and inaccessible to residents. Medications are centrally stored and in a locked medication room. Facility first aid kits (10) are fully stocked with manual was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to residents. Six (6) staff files were checked and have the required documents. The facility does handle resident's money/cash resources. HUB International Bond Company #40830507 for $15,000.00 was valid at the time of inspection. All the required documents are posted in the facility in a clearly visible area. LPA Jose Calderon noted the Administrator Heather Argueta Certification # 6007006740 expiration date of 11/25/2023 was NOT valid at time of visit. Commercial General Liability Policy #HFF0218512311policy period from 01/01/2023 to 05/01/2024 underwritten by Hudson Insurance company coverage 1,000,000/3,000,000 is valid at time of inspection. LPA Jose Calderon spoke to Administrator Heather Argueta who will email full copy of insurance contact which shows all coverages to LPA Jose Calderon no later than 04/02/2024. All the required documents are posted in the facility in a clearly visible area to all staff, clients, and guests. LPA Jose Calderon reviewed LIC500 and noted all staff associated to facility per LIS. LPA Jose Calderon reviewed the resident roster, LPA Jose Calderon confirmed residents’ interview are on resident roster.
SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Jose CalderonTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: HUNTINGTON RETIREMENT HOTEL
FACILITY NUMBER: 191600341
VISIT DATE: 03/22/2024
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LPA Jose Calderon advised the Administrator Heather Argueta to continuously monitor the Centers for Disease Control (CDC) website and Community Care Likening Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance.
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According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Jose Calderon did not observe deficiencies therefore no citations were issued at this time. Annual Licensing fee IS current. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Heather Argueta.
SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Jose CalderonTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC809 (FAS) - (06/04)
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