<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198204399
Report Date: 08/09/2022
Date Signed: 08/09/2022 12:47:58 PM


Document Has Been Signed on 08/09/2022 12:47 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: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: 49DATE:
08/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Maria BravoTIME COMPLETED:
01:00 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
Licensing Program Analyst (LPA) Perry Scott and LPM Janae Hammond conducted an unannounced required annual inspection, with a focus on infection control, to the above RCFE. Upon arriving at the facility LPA/LPM met with administrator Maria Bravo and informed her of the purpose of the visit. LPA Perry Scott & LPM Janae Hammond and administrator Maria Bravo toured the physical plant.

The facility is licensed to serve residents (age 60 and older) for (73) non-ambulatory and (7) bedridden residents. The facility has an approved Hospice Waiver for (7) residents. Currently, there are (49) residents and (30) staff employees.

The facility is in a commercial area near various businesses. It is a three-story building. The first floor, LPA/LPM toured the Lobby, Administrative and Business office, Reception area, Conference room, Beauty Salon and Laundry room. The second floor holds the Kitchen, Dining room and Resident Bedrooms. The third floor includes the Lounge, Library, Physical Therapy room, Patio, and resident bedrooms. The bathrooms are clean and working properly with grab bars and non-skid mats. The hot water temperature was measured and is within Title 22 Regulations (110F).

Adequate linen and personal hygiene supplies were in the laundry room and storage closets. Kitchen was checked and observed to be within Title 22 regulations. There was a sufficient supply of perishable and non-perishable foods in pantry, commercial refrigerator, and freezer.



The first aid kit is fully stocked, and mandatory licensing postings are posted in a prominent place on all floors. The outdoor activity space is on the patio and the area is free of visible hazards and debris. There are shaded areas with ample seating and additional chairs for resident activities. The facility has a signal system.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry ScottTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2022
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: VILLA REDONDO CARE HOME
FACILITY NUMBER: 198204399
VISIT DATE: 08/09/2022
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
26
27
28
29
30
31
32
LPA tested smoke detectors and carbon monoxide detectors and found them to be operating properly. There are no security bars or weapons on the premises. LPA observed fire extinguishers on all floors, and they were fully charged and maintained; last inspected on 07/31/22. LPA reviewed resident files and staff records as required. All records are upheld and in compliance. The last disaster drill was conducted on 07/27/22.

No deficiencies cited. Technical advisory note issued.

Exit interview conducted and copy of report provided to administrator Maria Bravo.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry ScottTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2