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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198202233
Report Date: 02/03/2022
Date Signed: 02/03/2022 11:30:24 AM

Document Has Been Signed on 02/03/2022 11:30 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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:DENKER HOUSEFACILITY NUMBER:
198202233
ADMINISTRATOR:GREG SWIFTFACILITY TYPE:
735
ADDRESS:20902 DENKER AVENUETELEPHONE:
(310) 212-6721
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY: 9CENSUS: DATE:
02/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Caregiver Leticia PachecoTIME COMPLETED:
11:30 AM
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On 02/03/2022 at 9:39 am, Licensing Program Analyst (LPA) Troy Agard conducted an unannounced required annual visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. Upon arrival, a risk assessment was conducted at the facility entrance. Based on the assessment, the facility is clear of Covid-19 infection. LPA verified that the facility has an approved mitigation plan report.

The facility is licensed for nine (9) ambulatory adults. The facility is approved to serve (nine) 9 ambulatory adults with a mental health diagnosis. Currently, there are eight (8) clients present during today’s visit.

LPA met with Caregiver, Leticia Pacheco and both toured the inside and outside grounds of the facility. LPA was not properly screened for Covid-19 symptoms and temperature was not checked.

During the tour, LPA observed the facility’s infection control practices. LPA did not observe a sanitizing station near the facility front entrance. All staff were observed with a face covering. LPA observed required postings throughout the facility.

All 5 rooms were inspected. All rooms are shared with the exception of 1. Bed linen were sufficient in amount, but mattresses needed bed covers, adequate lighting was provided, storage for client’s personal belongings was observed.

Furniture in the living room observed to be in good condition. There are no security bars or weapons on the premises. The client bathrooms were checked, toilets and water faucets worked properly. The water temperature measured at 114 F. A comfortable temperature was maintained in the facility.

LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Cleaning supplies were observed locked. Centrally stored medications were observed stored in their originally received containers and observed locked and inaccessible to residents in care. Two fire extinguishers were observed throughout the facility and fully charged.

Cont 9099C

SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: DENKER HOUSE
FACILITY NUMBER: 198202233
VISIT DATE: 02/03/2022
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Outside grounds were toured, no bodies of water observed. Walkways around the home were clear of hazards. Common areas were observed clutter free; front doorway was free of obstruction.

No deficiencies were cited during this visit.

One (1) technical advisory was issued for caregiver not performing routine symptoms screening on visitor

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

SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
LIC809 (FAS) - (06/04)
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