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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197800131
Report Date: 08/30/2021
Date Signed: 08/30/2021 05:39:36 PM

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:CHATEAU LONG BEACHFACILITY NUMBER:
197800131
ADMINISTRATOR:BEATRICE ROMEOFACILITY TYPE:
740
ADDRESS:3100 E. ARTESIA BLVD.TELEPHONE:
(562) 428-5371
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:184CENSUS: 78DATE:
08/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Beatrice RomeoTIME COMPLETED:
12:15 PM
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On 08/30/21, Licensing Program Analyst (LPA) Susan Campos conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA was allowed entry into the facility by Beatice Romeo, Administrator. LPA met with Ms. Romeo and explained the purpose of the visit. The facility is licensed to serve 184 residents, 60 years and older. Facility cleared for 178 non ambulatory and 6 bedridden. Rooms 102, 104, 105,106,107 and 108 are cleared to accommodate bedridden residents. The facility is approved hospice for 6 residents. The facility is a story two structure located in a commercial/ residential neighborhood. It consists of the following: Eighty (80) resident rooms/ bathrooms, 4 public bathrooms, lobby, beauty shop, TV room, kitchen, dining room, activity room, laundry room, medication room, 3 patios and Administrator offices. LPA toured the physical plant and inspected (8) resident bedrooms, 8 resident bathrooms (#104,102,108, 123, 223, 230, 236, 238). There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings was observed. 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 measured 107.5 degrees Fahrenheit. A comfortable temperature of 73 degrees was maintained in the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. A fire extinguisher was charged, smoke detectors and carbon monoxide were operable. Fire Drills were observed to be maintained in order and accurate. There is an emergency call station located at the front desk and pull cords in each room for emergencies and/or assistance. Exits were equipped with a sensor type alarm.

Evaluation Report Continues on LIC 809-C
SUPERVISOR'S NAME: Michael CavaTELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Susan CamposTELEPHONE: (323) 629-7445
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021
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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: CHATEAU LONG BEACH
FACILITY NUMBER: 197800131
VISIT DATE: 08/30/2021
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During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff and resident temperature logs were reviewed.

No deficiencies were cited during this inspection visit.

An exit interview was conducted and a copy of this report was provided to Beatrice Romeo.

SUPERVISOR'S NAME: Michael CavaTELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Susan CamposTELEPHONE: (323) 629-7445
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021
LIC809 (FAS) - (06/04)
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