191604283-2-23-2024-11-AS-SLEO-D2QVLZ-20240223153245

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191604283
Report Date: 02/23/2024
Date Signed: 02/23/2024 03:32:56 PM

Document Has Been Signed on 02/23/2024 03:32 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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	ADVOCACY FOR RESPECT AND CHOICE-LONG BEACH		FACILITY NUMBER:	191604283
ADMINISTRATOR:	ARIELLE NEAL		FACILITY TYPE:	775
ADDRESS:	4519 EAST STEARNS STREET		TELEPHONE:	(562) 597-4396
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90815
CAPACITY: 60		CENSUS: 60	DATE:	02/23/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	ARIELLE NEAL - Program Manager		TIME COMPLETED:	04:00 PM

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 02/23/2024 at around 9:30 AM, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with the Program Manager Arielle Neal. LPA explained the purpose of the visit and was accompanied by a staff member inside and outside the facility during this inspection. This facility is licensed to serve 60 adults, of which 15 may be non-ambulatory. The facility currently serves about 36 clients. The facility is located on a main street. The facility is composed of 5 buildings. Building 1 & 2 – Value Village Offices (non-program affiliated) Building 3 – The Multipurpose Building is composed of several office spaces, 1 tv room, 1 kitchen, 1 client locker room, 1 large meeting/activity/dining room, and several bathrooms.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: ADVOCACY FOR RESPECT AND CHOICE-LONG BEACH	FACILITY NUMBER: 191604283
	VISIT DATE: 02/23/2024

NARRATIVE

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Building 4 – The Activity Building is composed of a library room, art room, music & game room, salon room, staff break room, sick room, meeting room, computer room, and several bathrooms.
Building 5 – Workshop (non-program affiliated)
The outside grounds consist of 3 parking lots, 1 outside garden, 2 lunch areas, and several shaded seating areas.

The facility is currently renovating building 4. The areas of renovation are inaccessible to clients in care. The rooms under renovation are: sick room, meeting room, computer room, and gym.

The Administrator will be emailing plans of renovation to his LPA.

LPA toured the kitchen are and observed snacks for clients. Knives and toxins were kept in a locked storage room.

Documents are posted as mandated. The Long Beach Fire Department conducts a fire drill annually. The facility has several first aid kits around the facility. The facility holds an Annual Fire Permit that expires on 03/15/2024. There are several fire extinguishers on the premises, and they were last serviced on 03/23/2023.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: ADVOCACY FOR RESPECT AND CHOICE-LONG BEACH	FACILITY NUMBER: 191604283
	VISIT DATE: 02/23/2024

NARRATIVE

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Bathroom toilets and water faucets worked properly. Adequate lighting and toiletries accessible to clients. LPA tested hot water temperature and it measured between 105 to 120 degrees Fahrenheit.

5 staff records were reviewed, 5 out of 5 staff records had current First Aid Certificates, Criminal Record Clearances, Job Applications, Facility Trainings, and signed Employee Rights.

5 client records were reviewed and, 5 out of 5 client records had Admission Agreements and Medical Assessments, Consent Forms, Emergency Information, Appraisal & Needs Service Plan, Tuberculosis Test, and Personal Rights.

No deficiencies are being cited based on LPA observation, interviews conducted and record review in accordance with the California Code of Regulations, Title 22.

An exit interview was conducted and a copy of this report was left with the Administrator Shea Matherly.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

LIC809 (FAS) - (06/04)

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