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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198201977
Report Date: 03/27/2024
Date Signed: 03/27/2024 09:26:04 AM


Document Has Been Signed on 03/27/2024 09:26 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754



FACILITY NAME:SANCTUARY, THEFACILITY NUMBER:
198201977
ADMINISTRATOR:CATHERINE RAYMUNDOFACILITY TYPE:
740
ADDRESS:21410 MADRONA AVENUETELEPHONE:
(424) 558-3134
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY:6CENSUS: 0DATE:
03/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Catherine RaymundoTIME COMPLETED:
09:30 AM
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On 03/27/24, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced visit to the facility above to do a final walk through for closure. LPA met with Licensee Catherine Raymondo and explained the purpose of today’s visit.

LPA conducted a tour of the physical plant. During the tour it was observed that all bedrooms, bathrooms, and areas in the house, including the backyard were no longer occupied by residents. No residents were present within the facility. LPA observed the furniture in resident rooms have been removed.

Licensee stated the facility closure date was November 7, 2023. Licensee stated that Resident R1 relocated to Villa Sorrento on October 1, 2023, and R2 relocated to Huntington Retirement Home on November 7, 2023.

LPA received the original license.

No deficiencies were cited during today’s visit.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Wendy GibbsTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2024
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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