<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320235
Report Date: 01/13/2025
Date Signed: 01/13/2025 04:25:10 PM

Document Has Been Signed on 01/13/2025 04:25 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/
DIRECTOR:		MURRAY, MARSHAFACILITY TYPE:
735
ADDRESS:3839 OCANA AVE.TELEPHONE:
(562) 354-6589
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 3CENSUS: 3DATE:
01/13/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:18 PM
MET WITH:Marsha Murray, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 01/13/2025 at 12:18pm, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with the Marsha Murray, Administrator and the purpose of today’s visit was explained. The facility is licensed to operate for (3) non-ambulatory adults ages 18 through 59 of which (1) may be bedridden (bedroom #1). Currently, the home has (2) clients. The clients are Harbor Regional Center clients. One (1) the client have Restricted Health Care Conditions and none if the clients are utilizing postural supports or protective devices. The facility has an annual fee with the balance of $454.00 due on March 17, 2025. LPA provided pin #357053 to the facility with the option to make facility payment online.

The facility is a one story home located in a residential neighborhood. The property consists of the following: 3 client bedrooms, 2 common bathrooms, living room, a laundry room with a washer and dryer, kitchen, dining room, a garage with additional storage and an outdoor shaded area.

LPA conducted a records review of (2) client records, (5) staff records, (2) clients Personal & Incidental Records and (2) Client Medication Administration Records. LPA reviewed the facility disaster plan. All cliens and staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. The last emergency drill was conducted on October 2024.

At 2:21 pm LPA and Marsha Murray toured the inside and outside of the facility. Client rooms were checked. Mattresses and box springs were in good condition, adequate lighting was observed, plenty of dresser and closet space was observed. Walls and floors were clean and in good repair. Bed linens, comforters and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulation. Toilets and water faucets worked properly. Shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature properly measured between 105-120F (Kitchen 117.4F, Bathroom #1- 115.5F & Bathroom #2 116.7F).

Report continues on LIC 809-C.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: REM CALIFORNIA, LLC - OCANA
FACILITY NUMBER: 198320235
VISIT DATE: 01/13/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Carbon monoxide detector was observed and operational. Smoke detectors were working properly, fire extinguishers were fully charged, toxins and knifes were locked and inaccessible to clients. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. Outside grounds were toured and no bodies of water were observed. Exits/ Walkways around the home were free of debris and hazards.

During todays visit LPA did observe a deficiency.

LPA observed the following not in compliance: On 01/13/2024, LPA conducted a file review of staff files and did not observe an update CPR/first aid for 2 out of 5 employees.

Deficiencies Cited Under California Code of Regulations Title 22, Division 6, Chapter 1.

Exit interview conducted with Marsha Murray, Administrator.

Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) are cleared. *.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 01/13/2025 04:25 PM - It Cannot Be Edited


Created By: Zina Brown On 01/13/2025 at 02:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: REM CALIFORNIA, LLC - OCANA
FACILITY NUMBER: 198320235

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80075(f)
Health-Related Services
(f) Staff responsible for providing direct care and supervision shall receive training in first aid from persons qualified by agencies including but not limited to the American Red Cross.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, LPA did not observe completed First Aid/CPR certification for 2 out 5 staff which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2025
Plan of Correction
1
2
3
4
The administrator shall submit proof of completed First Aid/CPR training for all staff to the department by email at zina.brown@dss.ca.gov by POC Due Date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Janae Hammond
LICENSING EVALUATOR NAME:Zina Brown
LICENSING EVALUATOR SIGNATURE:
DATE: 01/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/13/2025


LIC809 (FAS) - (06/04)
Page: 3 of 3