197609105-11-23-2024-31-AS-RCOR-DBB2EP-20241123162015

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197609105
Report Date: 11/23/2024
Date Signed: 11/23/2024 04:21:42 PM

Document Has Been Signed on 11/23/2024 04:21 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	GRANDVIEW, THE		FACILITY NUMBER:	197609105
ADMINISTRATOR/ DIRECTOR:	FLORES, YENI		FACILITY TYPE:	740
ADDRESS:	2211 W 6TH STREET		TELEPHONE:	(213) 380-7000
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90057
CAPACITY: 215	TOTAL ENROLLED CHILDREN: 0	CENSUS: 156	DATE:	11/23/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Jaime Trejo - Facility Manager		TIME VISIT/ INSPECTION COMPLETED:	03:30 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	On 11/23/24, 09:15 am, Licensing Program Analysts, (LPAs') Raymond Comer, and Jose Gary Tan, conducted an unannounced annual visit to this facility. LPA met with Office Manager Jaime Trejo, who coordinated communications with Facility Administrator, Yeni Flores. LPA's spoke with the Administrator, via cellphone. Reason for the visit was disclosed and Administrator designated Mr. Trejo to sign the report Facility is licensed as a multi-story residence; the facility is fire cleared for two hundred and fifteen, (215) non-ambulatory residents; sixteen (16) of which may be bedridden. At 09:35 am, LPAs conducted the tour of the physical plant with Mr. Trejo, and observed the following: Physical plant was inspected for cleanliness and condition. Facility’s main door is the primary entry/exit access. Screening area is located immediately upon entrance. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Covid 19 prevention protocols are posted. Room temperature is comfortable; wall thermostat displays a setting of 73.0°F., within the required range. An approved Mitigation and Infection Control plan is on file. Hand washing, coughing etiquette, and other necessary signage are prominently displayed throughout the facility. Required postings observed to be current. Disaster drills were last conducted on 11/02/2024. Fire Detection/Protection system is present in the facility. Smoke and carbon monoxide detectors are hardwired, interconnected and observed to be tested as "passed" inspection by Los Angeles Fire Department on 02/26/2024. Fire Extinguishers are located throughout the facility; all serviced May 15, 2024. (LIC 809-C continued)

Eva Miller	TELEPHONE: (818) -596-4373
Raymond Comer	TELEPHONE: 818-401-8655
	DATE: 11/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2024

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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: GRANDVIEW, THE	FACILITY NUMBER: 197609105
	VISIT DATE: 11/23/2024

NARRATIVE

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Kitchen: At 10:10 am, kitchen was observed to be clean and an adequate supply of perishables and non-perishable food located in the fridge, freezer, and pantry. Food was properly labeled and stored. The emergency food is stored and observed to locked in a room labeled "Emergency Plan" across from the elevator and sprinkler valve room. Trash cans observed with lids. Sharps are stored in the kitchen inaccessible to residents.

Medication: At 10:35 am, LPAs' observed medications room to be secured and inaccessible to residents. Medications are stored in clear bins, refrigerator, and medication carts. Medication is prepared for residents and then placed in medication carts observed to be locked until distribution in the front office inaccessible to residents.

Laundry: At 11:50 am, LPAs observed two (02) laundry rooms, located on the sub-base level floor, to be clean and clear from obstruction. Residents are allowed to do their own laundry if they choose, and industrial laundry machines were observed to be locked and used by staff only. All laundry soap is locked in storage and is given by staff from the locked storage room if needed.

Commons: At 12:10 pm, LPAs observed community room, and activities room, to have sufficient tables and chairs for seating. Outside and surrounding area of the facility observed to be clean and clear from debris and obstruction.

Bedrooms At 10:53am LPAs observed random rooms with bathrooms located inside on the first and second floor to be appropriately furnished with sufficient lighting, bed linen and comforters on all beds. Bedrooms contain single and double occupancy. All bedrooms observed to be clean and clear from obstruction.

Bathrooms were observed to be clean and sanitary with necessary supplies and required safety fixtures (grab bars, anti-slip floor stripping). Hot water temperatures were measured randomly in multiple room;average temp range 107.8 - 114.0°F.; Within the required range. Hand towels are not shared.

[LIC 809C] Continued--

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) -596-4373
LICENSING EVALUATOR NAME: Raymond Comer	TELEPHONE: 818-401-8655
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2024

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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: GRANDVIEW, THE	FACILITY NUMBER: 197609105
	VISIT DATE: 11/23/2024

NARRATIVE

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Resident records: Facility records room was observed as locked and inaccessible to residents. A total of eights (8) resident files were reviewed for current IPP and/or Needs and Services plans, physician report, and admission agreements. Resident records appeared to be complete and current.

Staff records: Facility records room was observed as locked and inaccessible to residents. A total of seven (7) Staff files were reviewed. Criminal record clearances were present, and Staff are associated to this facility. Staff records appear to be complete and current.

There were no immediate health and safety hazards observed at the time of this inspection. Exit interview conducted and a copy of this report was given to the Administrator.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) -596-4373
LICENSING EVALUATOR NAME: Raymond Comer	TELEPHONE: 818-401-8655
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2024

LIC809 (FAS) - (06/04)

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