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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198200792
Report Date: 01/29/2025
Date Signed: 01/29/2025 02:44:52 PM

Document Has Been Signed on 01/29/2025 02:44 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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:EPI CENTERFACILITY NUMBER:
198200792
ADMINISTRATOR/
DIRECTOR:		DYE, MORGANFACILITY TYPE:
775
ADDRESS:3926 W. 139TH STREETTELEPHONE:
(310) 978-1254
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 25CENSUS: 31DATE:
01/29/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Administrator - Morgan DyeTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 01/29/2024, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) staff conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Administrator, Morgan Dye. CCLD staff explained the purpose of the visit and was accompanied by a staff member inside and outside the facility during this inspection.

This facility is licensed to serve 25 adults ages 18 to 59 years old.

The facility paid their Annual Licensing fees on 01/27/2025.

A total of 31 clients are currently registered in this facility.

Facility Layout: The facility is a one-story building. The building consists of 3 office spaces, 2 classrooms, 2 toilet restrooms, 2 changing rooms, 1 large community room with kitchen area and storage area, and an outside patio area with shaded seating.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: EPI CENTER
FACILITY NUMBER: 198200792
VISIT DATE: 01/29/2025
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Outside Grounds: were toured no bodies of water were observed, walkways around the building were clear of hazards, and there are no security bars or weapons on the premises.

Bathrooms: Toilets and water faucets worked properly. Adequate lighting and toiletries accessible to clients.

Medications: were inaccessible to clients in care. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law.

Miscellaneous: Documents are posted as mandated. Last Lockdown Disaster drill was conducted on 01/24/2025 and last Fire drill was conducted on 12/11/2024. The last Annual Fire Inspection was completed on 01/30/2024. First aid kit is fully stocked with manual. Fire extinguishers were observed near the kitchen area, and they were last serviced on 07/08/2024. The facility has a facility cell phone. There is plenty of activity space and activity tools for clients.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: EPI CENTER
FACILITY NUMBER: 198200792
VISIT DATE: 01/29/2025
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5 staff records were reviewed, 5 out of 5 staff records had required documentation.

5 client records were reviewed and, 5 out of 5 client records had required documentation.

Facility records were reviewed and facility had required documentation.

No deficiencies are being cited based observation and record review in accordance with the California Code of Regulations, Title 22.

An exit interview was conducted, and a copy of this report was left with the Administrator.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC809 (FAS) - (06/04)
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