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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320102
Report Date: 01/11/2024
Date Signed: 01/11/2024 01:00:04 PM

Document Has Been Signed on 01/11/2024 01:00 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:ICAN CALIFORNIA ABILITIES NETWORK TORRANCEFACILITY NUMBER:
198320102
ADMINISTRATOR:COLE, SILASFACILITY TYPE:
775
ADDRESS:2375 SEPULVEDA BLVDTELEPHONE:
(310) 374-8295
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY: 18CENSUS: 11DATE:
01/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Scott and Louise ElliotTIME COMPLETED:
01:15 PM
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On 01/11/2024 8:15 AM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Assistant Manager Elane Marroquin and explained the purpose of the visit. Directors Scott and Louise Elliott and Program Manager/Facility Administrator Jasmine Gillum arrived later and joined the visit.

The facility is located in a single-story commercial building and consists of the following rooms: a reception area; a large main space/lunchroom with tables and chairs, employees breakroom, clients breakroom, waiting lounge; 3 conference rooms, art room, kitchen, 3 activity rooms; janitor’s closet; locked storage room; 4 restrooms; case managers office; program managers office and a large open locker room with 96 lockers for both staff and clients.

The day program is licensed to operate for eighteen (18) developmentally disabled clients, ages 18 and over, of which four (4) may be non-ambulatory. There were eleven (11) clients, eight (8) direct support staff, and four (4) administrative staff. The Adult Day Program (ADP) sessions are every morning from 8:30 am-1:30 pm and afternoon from 2:00 pm – 6:00 pm.

LPA and Assistant Manager toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected and had adequate lighting and furnishings. Bathrooms were found to be within Title 22 regulations and were clean and operational. Smoke alarm system last tested and fire extinguishers last serviced on 9/5/2023. The last fire drill was conducted on 01/05/2024. The water temperature measured at 109.4 F.

Continue to LIC 809-C.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2024
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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: ICAN CALIFORNIA ABILITIES NETWORK TORRANCE
FACILITY NUMBER: 198320102
VISIT DATE: 01/11/2024
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Medications are locked & centrally stored in a locked room. The first aid kit has all required supplies.
All mandated inspection control posters were posted.

No deficiencies cited.

Exit interview conducted and a copy of this report was provided to the Director Scott Elliot.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
LIC809 (FAS) - (06/04)
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