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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320188
Report Date: 10/07/2021
Date Signed: 10/07/2021 10:34:31 AM

Document Has Been Signed on 10/07/2021 10:34 AM - It Cannot Be Edited

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:HARMONIOUS PLACE 2FACILITY NUMBER:
198320188
ADMINISTRATOR:WHITESIDES, DELISHAFACILITY TYPE:
735
ADDRESS:8901 DALTON AVETELEPHONE:
(310) 343-0677
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY: 4CENSUS: 0DATE:
10/07/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Delisha WhitesidesTIME COMPLETED:
11:00 AM
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On 10/07/2021, Licensing Program Analyst (LPA) Don Senaha conducted an unannounced case management visit at this facility and met with administrator Delisha Whitesides and explained the purpose of today’s visit is to conduct an inspection of the surveillance system.

During today's inspection, LPA observed the placement of the six (6) surveillance cameras. LPA observed the video surveillance via administrator computer is not being utilized in any private areas of the facility. LPA confirmed with the administrator there will be placement of physical signs posted in the areas that will be subject to video surveillance. LPA received the updated floor plan of the placement of the six (6) surveillance cameras

LPA observed no clients present at the time of the visit and Administrator Delisha Whitesides confirmed the facility does not have any clients onboard at the time of this visit.

An exit interview was conducted and a copy was left with the Administrator Delisha Whitesides.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Don Senaha
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2021
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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