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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606410
Report Date: 11/07/2023
Date Signed: 11/07/2023 11:45:11 AM


Document Has Been Signed on 11/07/2023 11:45 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:CARING PARTNERS, INCFACILITY NUMBER:
197606410
ADMINISTRATOR:TERESA SANTOSFACILITY TYPE:
740
ADDRESS:19607 WIERSMA AVENUETELEPHONE:
(562) 333-8141
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:6CENSUS: 3DATE:
11/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Administrator Ed Francisco TIME COMPLETED:
12:05 PM
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On 11/07/23 at 8:10 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced Annual/Required inspection to Caring Partners Inc. Upon arrival LPA was greeted by Direct Support Professional (DSP) Sonny Mica who contacted the Administrator, Edgardo Francisco. The Administrator arrived at 8:35 a.m., and LPA explained the reason for the visit. The House Manager Teresita Llamas arrived at 8:50 a.m., and LPA explained the reason for the visit. This home is licensed to serve (6) residents. The facility is approved to have (4) non-Ambulatory and (2) Ambulatory residents aged 60 and above. The home is vendorized through Harbor Regional Center. There were (3) residents in care during the time of this visit. The last emergency disaster/fire drill was conducted on 3/10/2023. The Administrator Certificate expires on 4/27/2025 #6025870740. During today's visit LPA inspected the physical plant inside and outside, reviewed the food supply, tested the smoke/carbon monoxide detectors, reviewed (3) staff files, (3) resident files, medications, and medication administration records for (3) residents and P&I.

This home contains 4 bedrooms, 3 bathrooms, living room, Family room with covered fireplace, kitchen, dining room and an attached garage. LPA toured the physical plant with the Administrator and House Manager and observed all (4) resident bedrooms, contained required furniture, lamps, dresser, chair, and closet space. The three bathrooms contain a working toilet, basin, and water faucet, walk in shower with grab bar, shower chair, bathmat or nonskid material. The temperature measured at 117.6 – 118.0 degrees F. The smoke detectors were battery operated, tested and observed to be working properly. The carbon monoxide detector was located in the kitchen, tested, and functioning properly. There were (1) fire extinguisher located in kitchen and garage, fully charged and up to date. The kitchen was toured and contained working appliances; refrigerator, stove, oven and contained dishware, cups, plates, utensils, pots, and pans. The knives were secured in a kitchen cabinet. The cleaning agents and toxins was locked underneath the kitchen sink. The pantry was well stocked with canned goods, pasta, cereals, and the food supply contained a sufficient supply with a two-day supply of perishables and a seven-day supply of non-perishables that met title 22 guidelines. Walls and floors, cabinets and counters were clean and sanitary throughout the home. (Report continued on LIC809C.)
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel BaptisteTELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:
DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/07/2023
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: CARING PARTNERS, INC
FACILITY NUMBER: 197606410
VISIT DATE: 11/07/2023
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The outdoor grounds were toured and inspected, and the patio was well maintained with a shaded seating area accessible for resident use. The garage contained a working washer and dryer, extra food, storage supplies and PPE supplies.

Exit interview conducted with Edgardo Francisco, Administrator and Teresita Liamas, House Manager, a copy of this report was provided.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel BaptisteTELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023
LIC809 (FAS) - (06/04)
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