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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197607718
Report Date: 05/27/2021
Date Signed: 05/28/2021 09:16:54 AM

Document Has Been Signed on 05/28/2021 09:16 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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:CENTINELA ASSISTED LIVING CENTREFACILITY NUMBER:
197607718
ADMINISTRATOR:GWENDOLYN CRAIGFACILITY TYPE:
740
ADDRESS:1000 S FLOWER STTELEPHONE:
(310) 674-3216
CITY:INGLEWOODSTATE: CAZIP CODE:
90301
CAPACITY: 96CENSUS: 47DATE:
05/27/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Gwendolyn Craig, AdministratorTIME COMPLETED:
03:45 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
Licensing Program Analyst (LPA) Erik Brown made and unannounced inspection to this facility. The purpose of today’s visit was to conduct the Required Annual inspection. During today’s visit, LPA met with Gwendolyn Craig, Administrator and explained the reason for the visit. The facility has a capacity of 96 clients. The facility currently has 47 clients in care.

The above facility is a single-story business building located in a residential neighborhood. Upon entry to the facility, LPA observed hand sanitizer, a visitor and temperature log, paper towels and a thermometer. LPA Brown toured the facility main office/receptionist area, administrator office, medication room, dining room, kitchen, bedrooms, bathrooms, male and female's restrooms, public restrooms, activity room, hair salon, storage closet, laundry room located on the other side of the parking lot, patios, shaded area, and indoor/outdoor activity areas. Covid postings and other documentation are posted as mandated. Bedrooms contain the furniture mandated. Bathrooms are clean and operational. Personal accommodations observed for safety, privacy, and comfort, including grab bars, and non-skid surfaces mats.



Water temperature measured between 105-120 degrees F. Common areas were clean and clear of hazards; doorways were free of obstructions.

Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Facility has operable smoke detectors/carbon monoxide detectors. Fire extinguisher was fully charged and operational, toxins and sharps are locked and inaccessible to potential clients. First aid kit was available. Outside grounds were toured and no bodies of water were observed.

No deficiencies cited during this visit. Exit Interview Conducted and a copy of this report was given.

SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Erik Brown
LICENSING EVALUATOR SIGNATURE: DATE: 05/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/27/2021
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