198204079-1-24-2024-11-AS-AINZ-CZST7H-20240124132846

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198204079
Report Date: 01/24/2024
Date Signed: 01/24/2024 01:28:54 PM

Document Has Been Signed on 01/24/2024 01:28 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME:	SPRING SENIOR ASSISTED LIVING		FACILITY NUMBER:	198204079
ADMINISTRATOR:	CRAIG WEECH		FACILITY TYPE:	740
ADDRESS:	20900 EARL STREET		TELEPHONE:	(310) 370-3594
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	51	CENSUS: 27	DATE:	01/24/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:36 AM
MET WITH:	Gregory Weech/Administrator		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 1/24/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Gregory Weech/Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (51) non-ambulatory residents ages 60 and above. The facility has an approved hospice waiver for (12) patients. This facility consists of (37) private resident bedrooms with a bathroom, kitchen, living room, activity/entertainment room, dining room, two common bathrooms, a laundry room, and a patio on the first floor with a shaded area. LPA Iniguez toured the physical plant with the administrator. There were no bodies of water or obstructions on the premises. A total of (6) rooms were inspected: #106, #110, #111, #216, #201, #200. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the resident’s personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. A company is in charge of the carbon monoxide/smoke detectors detectors, which were in operable condition. The water temperature measured adequately between (105°F-120°F). Evaluation Report Continues LIC 809-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SPRING SENIOR ASSISTED LIVING	FACILITY NUMBER: 198204079
	VISIT DATE: 01/24/2024

NARRATIVE

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LPA Iniguez observed the facility to be clean, sanitary and appropriately furnished during the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and inaccessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was available and maintained adequately. All fire extinguishers were charged and were operable. A review of (5) residents' service files, (5) staff personnel files, and (5) Medication Administration Records (MAR) were observed, LPA did not observe any discrepancies at the time of the visit. The first AID kit was checked. The last fire disaster drill was on 12/8/2023.
LPA observed the facility's infection control practices. A copy of the liability insurance was provided to LPA during the visit.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies; therefore, no citations were issued at this time.

An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Gregory Weech /Administrator.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

LIC809 (FAS) - (06/04)

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