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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198204999
Report Date: 06/12/2024
Date Signed: 06/12/2024 03:23:29 PM


Document Has Been Signed on 06/12/2024 03:23 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:AMERICARE ASSISTED LIVING OF WESTCHESTERFACILITY NUMBER:
198204999
ADMINISTRATOR:PATRICK BAUTISTAFACILITY TYPE:
740
ADDRESS:8501 RAMSGATE AVENUETELEPHONE:
(310) 641-5808
CITY:LOS ANGELESSTATE: CAZIP CODE:
90045
CAPACITY:6CENSUS: 6DATE:
06/12/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Leia DimalantaTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Sparkle Day conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one-year inspection. LPA met with Leia Dimanlanta, Administrator and the purpose of the visit was discussed. Facility is licensed to serve 6 residents ages 60 and over. The facility is approved for (4) non ambulatory residents, 2 bedridden residents ( Rm #4 & #5) and approved hospice waiver for 2 resident. None of the residents are receiving home health. Two are on hospice or hospice care services. The facility does not handle any of the residents’ money.

This home is a two story home consisting of: (6) resident bedrooms, 3) Full bathroom,living room, kitchen with dining area, laundry room (located in the kitchen) and an outdoor shaded patio area. LPA toured the Resident bedrooms 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, water temperature measured between 118F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards; doorways were free of obstructions.

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. Smoke detectors were working properly and fire extinguisher was fully charged. Carbon monoxide detector was operational. First Aid kit was available. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises.

An exit interview was conducted, and a copy of Report and Appeal Rights provided.

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Sparkle DayTELEPHONE: (424) 544-1075
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2024
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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