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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608174
Report Date: 08/22/2024
Date Signed: 08/29/2024 08:59:44 AM


Document Has Been Signed on 08/29/2024 08:59 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:FRANCO RESIDENTIAL HOME CAREFACILITY NUMBER:
197608174
ADMINISTRATOR:MARIANA FRANCOFACILITY TYPE:
740
ADDRESS:1921 SOUTH CORNING STREETTELEPHONE:
(310) 837-7783
CITY:LOS ANGELESSTATE: CAZIP CODE:
90034
CAPACITY:3CENSUS: 0DATE:
08/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Mariana FrancoTIME COMPLETED:
12:30 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) Sparkle Day conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Mariana Franco , Administrator and the purpose of the visit was discussed. The facility is licensed to serve (3) elderly residents ages 60 and over; of which (2) may be ambulatory and (1) may be non-ambulatory in room #2. There are currently (0) clients in placement.

The facility is a single story duplex ,the front unit being the licensed facility. Home is a single-family residence with 3 bedrooms, 1 bathroom, living room, dining room, kitchen, front yard, back yard, and laundry area that is located off backyard on the side of the house. LPA and Ms Franco toured the Resident bedrooms . All rooms had the required furniture, bed linens and closet/drawer space required to accommodate each resident comfortably.Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured between 115 F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions.

Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises.

During todays visit LPA did not observe any deficiencies.

Exit interview conducted with Mariana Franco, Administrator.

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Sparkle DayTELEPHONE: (424) 544-1075
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2024
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