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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191604283
Report Date: 07/27/2022
Date Signed: 07/27/2022 08:51:26 PM

Document Has Been Signed on 07/27/2022 08:51 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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:ADVOCACY FOR RESPECT AND CHOICE-LONG BEACHFACILITY NUMBER:
191604283
ADMINISTRATOR:JENNY LINFACILITY TYPE:
775
ADDRESS:4519 EAST STEARNS STREETTELEPHONE:
(562) 597-4396
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY: 60CENSUS: 11DATE:
07/27/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
10:48 AM
MET WITH:Arielle Neal - Program ManagerTIME COMPLETED:
11:59 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
On 07/27/22 at 10 am Licensing Program Analyst (LPA) Ernand Dabuet initiated a Collateral visit at this day program facility. LPA met with program manager Arielle Neal. LPA explained the purpose of this visit is to gather information regarding a current complaint about Harrison's Board and Care for Homes, Inc. Complaint number 11-AS-20220719162624.

The visit consisted of an interview with resident #2 (R2) and witness #2 (W2). (R2) resides at Harrison's Board and Care. The details on the interview are documented on LIC 812 crossed reference with Harrison's Board and Care Homes, Inc. #198201097.

An exit interview was conducted with Arielle Neal and a copy of the report was provided.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2022
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 1