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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198204399
Report Date: 10/02/2024
Date Signed: 10/03/2024 08:51:13 AM


Document Has Been Signed on 10/03/2024 08:51 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245



FACILITY NAME:VILLA REDONDO CARE HOMEFACILITY NUMBER:
198204399
ADMINISTRATOR:MARIA BRAVOFACILITY TYPE:
740
ADDRESS:237 REDONDO AVENUETELEPHONE:
(562) 434-9931
CITY:LONG BEACHSTATE: CAZIP CODE:
90803
CAPACITY:80CENSUS: DATE:
10/02/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:12 PM
MET WITH:TIME COMPLETED:
03:15 PM
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On 10/02/2024 at 12:10pm, Licensing Program Analyst (LPA) Zina Brown and Licensing Program Manager (LMP) Janae Hammond conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one- year inspection. LPA met with Maria Bravo , Administrator and David Hernandez, Assistant Administrator and the purpose of the visit was discussed. Facility is licensed to serve 73 non- ambulatory residents, 7 bedridden residents and an approved hospice waiver for 7 residents. The facility does handle residents cash resources.
The facility has residents diagnosed with the following:
  • 15 dementia residents
  • 15 receiving home health residents
  • 10 hospice care services residents.

    The facility is a 3 story building consisting of:
  • 1st floor: Lobby, business offices, conference room, salon, laundry, designated smoking area outside, and parking lot
  • 2nd floor: 20 resident rooms, outdoor shaded area, kitchen, and dining room and an emergency evacuation chair is located on the 2nd floor stairwell.
  • 3rd floor: 20 resident rooms, activity room, library, medication and storage room.
LPA and LPM toured the facility with David Hernandez, Assistant Administrator and inspected resident bedrooms which had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. Common areas were clean and clear of hazards; doorways were free of obstructions.

Report continues on LIC 809-C

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Zina BrownTELEPHONE: 424-544-1075
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2024
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: VILLA REDONDO CARE HOME
FACILITY NUMBER: 198204399
VISIT DATE: 10/02/2024
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Kitchen was checked and observed to be within Title 22 regulations. Perishable and non-perishable food supply was checked. All cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Outside grounds were toured and no bodies of water were observed. Walkways around the facility were clear of hazards. There are no security bars or weapons on the premises.

Due to time constraints, LPA was unable to complete the inspection, LPA will return at a later date.
No deficiencies were cited during the time of this visit.

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

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Zina BrownTELEPHONE: 424-544-1075
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
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