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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320235
Report Date: 02/22/2024
Date Signed: 02/22/2024 02:15:56 PM

Document Has Been Signed on 02/22/2024 02:15 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:REM CALIFORNIA, LLC - OCANAFACILITY NUMBER:
198320235
ADMINISTRATOR:MURRAY, MARSHAFACILITY TYPE:
735
ADDRESS:3839 OCANA AVE.TELEPHONE:
(562) 354-6589
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 3CENSUS: 3DATE:
02/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:39 PM
MET WITH:Program Director Marsha MurrayTIME COMPLETED:
02:30 PM
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On 02/22/24, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Program Director Marsha Murray as the purpose of the visit was explained. The facility is licensed to serve 3 non-ambulatory clients ages 18-59, of which 1 may be bedridden in bedroom #1. Clients are linked to the Harbor regional center, current census is 3. Program director provided with facility fee information, surety bond is active.

The facility is a single-story structure located in a residential neighborhood and consists of the following: (3) bedrooms, (2) bathrooms, living room, dining room, family room, kitchen, office area, a closet that houses PPE and emergency water supply, a laundry room, and a backyard with a shaded seating area. Client bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to clients. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to clients, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards.

LPA conducted a records review of 2 staff records, 3 client records, and 3 medication administration records, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 02/08/24, 2 fire extinguisher fully charged, carbon monoxide and smoke detectors are interconnected and operational. A land line and internet service was observed. During todays visit no discrepancies observed, no citations issued.

Exit interview conducted with Program Director Marsha Murray, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2024
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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