198320032-7-30-2021-11-AS-ASOO-C54VHK-20210720162715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198320032
Report Date: 07/20/2021
Date Signed: 07/30/2021 05:58:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	KENSINGTON REDONDO BEACH, THE		FACILITY NUMBER:	198320032
ADMINISTRATOR:	MAY, ROBERT		FACILITY TYPE:	740
ADDRESS:	801 S PACIFICA COAST HIGHWAY		TELEPHONE:	(424) 241-2064
CITY:	REDONDO BEACH	STATE: CA	ZIP CODE:	90277
CAPACITY:	132	CENSUS: 95	DATE:	07/20/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Robert May, Executive Director		TIME COMPLETED:	04:00 PM

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Licensing Program Analyst (LPA) Ana Soto conducted an unannounced Annual required visit and an infection control inspection to the above facility. LPA was met by Robert May, Executive Director and the purpose of today’s visit was explained.

There are currently (95) residents in the facility. The facility has 3 sections within the facility. The assisted Living, Connections, and Haven sections. (38) residents are ambulatory and (60) are non-ambulatory. The facility is a two-story structure located in a residential neighborhood. It consists (116) bedrooms, (133) bathrooms, shaded court yard, shaded front yard with water fountain, and trash area in the back of building in the south parking lot. 1st floor; kitchen, staff room, laundry room, dining room, library, 3 restrooms (2 inside building and 1 outside court yard area, lobby area, reception area, executive office, copy room, hallways, bistro, cinema room (team member desk,) electric room, Director of team support office, Maintenance closet, French dining room, Loggia with fire place, dining supplies closet, activity room. 2nd floor: connections and haven sections. Connection section; closet with medical supplies, spa, linens storage, nursing supply storage, cafe, activity room, family room with fireplace and office, trash closet, electrical closet, toxic supplies closet, patio. Haven section; cafe, activity room with sink, ocean room with balcony and fireplace, laundry room, trash closet, electrical closet, medication carts in all 3 sections. Assisted living on 1st floor and 2nd Floor with salon, and medical office.

LPA and Robert and Raquel Martinez (Business Director) toured the entire facility inside and out. Documents are posted as mandated. 95 Rooms are occupied by residents and contain the mandated furniture. All bathrooms are clean and operational. First aid kit complete with manual; smoke detectors and carbon monoxide detector were in compliance and operational. No firearms are stored at facility and water fountain present but does not present a hazard for residents. Medications are stored, locked and inaccessible to residents.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: KENSINGTON REDONDO BEACH, THE	FACILITY NUMBER: 198320032
	VISIT DATE: 07/20/2021

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Medications and file are current. 4 Staff files are current. Ample supply of perishable and nonperishable food, hot water temperature is 111 degrees Fahrenheit, linens and personal hygiene supplies are adequate, hazardous toxins and/or sharp items are inaccessible to residents, 10 fire extinguishers are fully charged. Exit, walkways and/or passageways, front and court yard are free of debris and/or hazards. The facility is in excellent repair.

During the visit, LPA observed the facility infection control practices. LPA observed a sanitizing station at the facility entry and the court yard, visitors are logged, and temperature checked, sanitizer/soap in the all bathroom and additional sanitation supplies are locked in the copy room. LPA observed staff and clients wearing masks, residents’ private rooms will be converted to isolation rooms (if needed) and/or residents will be moved to a suite for isolation and required postings throughout the facility. The facility has an approved Mitigation plan. The resident’s temperatures are checked and logged once a day. PPE's are enough for 30 days.

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

An exit interview conducted with Robert May, Execute Director and copy of report provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

LIC809 (FAS) - (06/04)

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