198320032-8-16-2023-11-AS-WGIS-CURTBX-20230816143554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198320032
Report Date: 08/16/2023
Date Signed: 08/16/2023 02:36:03 PM

Document Has Been Signed on 08/16/2023 02:36 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:	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: 119	DATE:	08/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Robert May		TIME COMPLETED:	02:45 PM

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On 08/16/23, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit to the facility listed above. LPA met with Executive Director, Robert May, and explained the purpose of today's visit. The facility currently has 119 residents.
Physical Plant/Structure The facility is a two-story structure located in a residential neighborhood. The facility has 3 sections within the facility. The assisted Living, Connections, and Haven sections. It consists of (116) bedrooms, (133) bathrooms, shaded courtyard, 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, 4 restrooms (3 inside building and 1 outside courtyard 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 fireplace, dining supplies closet, and 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, and patio. Haven section; cafe, activity room with sink, ocean room with balcony and fireplace, laundry room, trash closet, and electrical closet. A medication carts is in all 3 sections. Assisted living on 1st floor and 2nd Floor with salon, and medical offices. All walkways, paths and passageways were clean, clear, and free of debris, hazards, and obstructions.
Apartments/Rooms LPA toured apartments which house residents with independent living capabilities and assisted living. They include 1 bedroom, 1 bathroom, living room, kitchenet, and ample storage space for resident’s personal belongings. Residents have the option to furnish apartments with their own furniture. There are furnishings available upon request.
Bathrooms Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, showers were free of mold/mildew and had a non-skid mat or chair in place. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. In rooms, the water temperature was measured between 111.6-and 114.4-degrees Fahrenheit.

Continued on LIC809-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Wendy Gibbs	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: KENSINGTON REDONDO BEACH, THE	FACILITY NUMBER: 198320032
	VISIT DATE: 08/16/2023

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Kitchen LPA toured the commercial-size kitchen, located on the first floor. All appliances were in good working order. LPA observed an adequate supply of cutleries, pots and pans that were well maintained and in good repair. The kitchen was observed to be within Title 22 regulations. LPA observed a 4-day supply of perishable foods and a 10-day supply of non-perishable foods. All food was properly stored and labeled. All knives and toxins are secured and inaccessible to residents. LPA observed the food service areas and dining rooms, they were found to be clean and have ample seating for all residents. LPA observed a menu posted near the dining room and resident dietary orders posted in the kitchen. LPA observed the bistro to have snacks and drinks available to residents throughout the day.
Common Areas The common areas living room, dining rooms, activity room, theater room, private dining room, patio areas and lounges were appropriately furnished allowing spacing by residents. LPA observed books, games, crafts, and activities for residents. An event calendar is posted outside of activity rooms and theater. LPA observed ample lighting in all common spaces. A comfortable temperature was maintained in the facility. Common areas were clean and clear of hazards; doorways were free of obstructions.
Safety LPA observed multiple fires extinguishers throughout the community that are fully charged. Fire doors close automatically when alarms are set off. Additionally, there is a sprinkler system throughout the facility that is scheduled to be inspected and serviced on 08/29/23. Last emergency drill was on 08/06/23. All necessary safety postings were observed including emergency numbers, and disaster plan. There is a working landline telephone. LPA inspected the First Aid Kit and found it contains all required items and a manual. The generators are checked and ran weekly. LPA reviewed and received a copy of the Liability Insurance.
Infection Control LPA observed facilities infection control procedures, all guests need to check in at the main entrance. All visitors are screened before entry. LPA observed necessary infection control posting in common areas. There are sanitizing stations throughout the facility.
Medications LPA reviewed the centrally stored medications for ten (10) residents. LPA observed medications to be in their original packaging. LPA reviewed the Medication Administration Records (MAR) and found that it was consistent with the medications. All medications are secured in the locked medication rooms and are inaccessible to residents.

Continued on LIC809-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Wendy Gibbs	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: KENSINGTON REDONDO BEACH, THE	FACILITY NUMBER: 198320032
	VISIT DATE: 08/16/2023

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File Review & Interviews LPA reviewed ten (10) Resident files and found they contained the required documents. LPA reviewed ten (10) staff and Executive Director files and found they contained the required documents, certifications, and training. LPA interviewed seven (7) Residents, and seven out of seven stated they were happy and satisfied with the services they receive here. LPA interviewed ten (10) staff, and all were able to explain policy, procedures, and residents’ personal rights.

No deficiencies were cited during today’s visit.

LPA Gibbs conducted and exit interview with Executive Director, Robert May, and a copy of this report was provided.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Wendy Gibbs	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC809 (FAS) - (06/04)

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