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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198202967
Report Date: 11/19/2022
Date Signed: 11/19/2022 12:18:29 PM

Document Has Been Signed on 11/19/2022 12:18 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:ANAND CARE CENTER IIIFACILITY NUMBER:
198202967
ADMINISTRATOR:MEHUL PATELFACILITY TYPE:
735
ADDRESS:11143 SOUTH PRARIE AVETELEPHONE:
(310) 419-1225
CITY:INGLEWOODSTATE: CAZIP CODE:
90303
CAPACITY: 20CENSUS: 9DATE:
11/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Chetan PatelTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Perry Scott conducted an unannounced required annual visit, with a primary focus on infection control measure using the new Care Inspection Tool. Upon arrival at the facility, LPA Scott met with Chetan Patel, office manager, and the purpose of the visit was explained. The facilities annual fees current.

The facility is a two-story converted hotel building located in a business area which consists of 18 bedrooms, 18 bathrooms, kitchen, dining room, laundry room, storage room, 7 detached carports, shaded area, and indoor/outdoor activity areas.

As part of the inspection, my primary focus was on infection control. LPA observed the facility’s infection control practices: LPA observed a sanitizing station at the facility entrance. PPE supplies are readily available to staff and residents, and additional supplies are stored. Sufficient paper, cleaning, and disinfecting supplies were observed. The facility has the mandated COVID infection control posters.

LPA Scott and Mr. Patel tour the facility at 11:00am. Resident bedrooms contain the required furniture, bed, one chair, nightstand, adequate lighting, a closet, and chest of drawer's space. There was ample space to accommodate each resident comfortably. Documents were posted as mandated on the wall in the office and on the bulletin board and in the dining area.

Continued on LIC809C
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: ANAND CARE CENTER III
FACILITY NUMBER: 198202967
VISIT DATE: 11/19/2022
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The following Title 22 regulated areas were audited and found to be complying: Bedrooms contain the required furniture. The resident's bedrooms were inspected for safety, privacy, and comfort. The bathrooms are operational. First aid kit is fully stocked with manual, hot water temperature 106.4 degrees F; adequate lighting, and a working telephone. Additionally, LPA observed a fire alarm pull station, smoke detectors were complying, fire extinguishers are fully charged, medications were centrally stored and properly locked in the kitchen cabinet.

LPA observed ample supply of perishable and nonperishable food, adequate linen supply, no firearms on the premises, all exit doors were complying, all outdoor and indoor passageways are free of obstruction, covered trash cans, and no bodies of water present. Hazardous items are inaccessible to clients, the yard is free of debris and hazards.

During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff and residents, sanitizing stations (Located in common areas and restrooms). LPA observed staff and residents were wearing face coverings, an isolation room and required postings throughout the facility. LPA observed the facility has a 90-day supply of Personal Protective Equipment (PPE).

LPA advised the Administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) Provider Informational Notices (PIN) for any updates relating to COVID-19 and other required guidance.



During today’s visit there were no deficiencies observed and no citations issued.

Exit interview was held and a copy of the report were provided to Chetan Patel, office manager.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2022
LIC809 (FAS) - (06/04)
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