197608174-8-10-2023-11-AS-PSCT-CUKRBG-20230810125244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197608174
Report Date: 08/10/2023
Date Signed: 08/10/2023 12:52:52 PM

Document Has Been Signed on 08/10/2023 12:52 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:	FRANCO RESIDENTIAL HOME CARE		FACILITY NUMBER:	197608174
ADMINISTRATOR:	MARIANA FRANCO		FACILITY TYPE:	740
ADDRESS:	1921 SOUTH CORNING STREET		TELEPHONE:	(310) 837-7783
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90034
CAPACITY:	3	CENSUS: 0	DATE:	08/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:57 AM
MET WITH:	Veronica Franco		TIME COMPLETED:	01:15 PM

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On 08/10/23, Licensing Program Analyst's (LPA) Perry Scott conducted an unannounced annual required visit using the new Cares Tool. LPA was met by Licensee, Mariana Franco, and Veronica Franco, caregiver, and the purpose of today’s visit was explained. 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 facilities annual fees are current.

The facility is a single-story structure located in a residential neighborhood. 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.

LPA and Veronica Franco toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided in all rooms, storage for client personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational.

The water temperature was within Title 22 guidelines. A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is enough perishable and non-perishable food available which is stored properly. Fire extinguishers was charged, smoke detectors and Carbon Monoxide were operable.

Report continued on LIC809-C

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry Scott	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: FRANCO RESIDENTIAL HOME CARE	FACILITY NUMBER: 197608174
	VISIT DATE: 08/10/2023

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During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA advised the administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time.

Exit interview held and a copy of the report was provided to Mariana Franco, Licensee.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry Scott	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

LIC809 (FAS) - (06/04)

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