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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320250
Report Date: 04/05/2022
Date Signed: 04/05/2022 03:15:14 PM


Document Has Been Signed on 04/05/2022 03:15 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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754



FACILITY NAME:OAKMONT OF TORRANCEFACILITY NUMBER:
198320250
ADMINISTRATOR:BELSON, MYLAFACILITY TYPE:
740
ADDRESS:3620 LOMITA BLVDTELEPHONE:
(424) 376-3300
CITY:TORRANCESTATE: CAZIP CODE:
90905
CAPACITY:126CENSUS: 87DATE:
04/05/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Myla BelsonTIME COMPLETED:
03:30 PM
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On 04/05/22 Licensing Program Analyst, LPA Jeremiah Randle, LPA Gail Johnson and LPA Martessa Brown initiated a pre-licensing inspection at this facility. An application was submitted to CCLD on 10/21/2021. In the initial license application for a Residential Care Facility for the Elderly, ages ranging from 60 years and above. The applicant requested capacity of 126 individuals, of which zero (0) ambulatory, (118) non-ambulatory, and (8) bedridden.

Structure:

The facility has (87) apartment rooms with a restroom inside each. The facility is a 3 story with a basement and parking garage situated in a residential neighborhood. There is a memory care side with and a assisted living side. There is (28) memory care and (58) in the assisted living. (2) apartment rooms in memory care are shared. The facility interior includes common area living room, dining, kitchen, activity room, theater room and laundry area. The common area living room has a fireplace with a screen and uses gas not wood. The common living room area included an adequate number of chairs, couches, tables, a poker table and a library. The kitchen has stoves, a walk-in freezer, and a walk-in refrigerator. The exterior is rear fenced throughout. The passageways, walkways, and steps are free from obstructions. The courtyard and patio area is covered and has a table with chairs for additional seating.

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 395-3554
LICENSING EVALUATOR NAME: Jeremiah RandleTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022
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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: OAKMONT OF TORRANCE
FACILITY NUMBER: 198320250
VISIT DATE: 04/05/2022
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Resident Apartment Rooms: The facility has (87) apartment rooms. LPA inspected each room.

Appliances:

Stove burners, oven, microwaves, washers, and dryers are working. There is a walk-in refrigerator in the kitchen and a walk-in freezer. The refrigerator has a measured temperature of at 38 degrees Fahrenheit for appropriate food storage. A freezer is at (-4 ) degrees Fahrenheit.

Toxins:

All toxins are locked/stored in a locked room in the basement.

Water Temperature:

Staff inspected 50 apartment rooms sink and water tested between 105 and 118 degrees F.

Medications, First-Aid Kit & Book:

A first aid kit stored in the locked cabinet in the kitchen has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and current first aid manual locked and inaccessible to residents. The resident's medications are stored in the med rooms inaccessible to residents on the 1st floor which is the memory care floor and another medication room is on the basement floor.

Residents & Staff Files:

The applicant is not handling cash resources of residents. Records of staff and residents will be stored in the business office.

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 395-3554
LICENSING EVALUATOR NAME: Jeremiah RandleTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: OAKMONT OF TORRANCE
FACILITY NUMBER: 198320250
VISIT DATE: 04/05/2022
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Reading Material, Games, Equipment & Materials:

The facility has board games, books, magazines, and other recreational materials for the resident’s use all stored in the common area in the living room. A poker table, a library, TV’s, computers for residents , beauty salon, fitness center and a theater room.

Pool/Jacuzzi & Pets: There are pets that are kept in residents rooms per agreement , jacuzzi, or pool in the fenced area.

Bedrooms Staff:

There is no designated bedroom for staff.

Bathrooms:

All apartment room bathrooms have a working toilet, washbasin, shower, grab bars and non-skid surfaces.

Linens & Hygiene Supplies:

Residents are bringing their own beds. An adequate supply of linen stored in the hall closet adjacent to all resident bedrooms.

Emergency Phone Numbers, Exit Plan & Menu:

Emergency phone numbers. exit plan and menu are posted and readily available for review in the kitchen area. There are 27 fire extinguishers mounted on the walls throughout the facility and fully charged. A telephone line is available to residents.

Food Service:

Dishes, cups, and flatware are stored in the kitchen cabinets, inspected and in good repair. Knives, cutlery, and other sharp kitchen utensils are stored in the kitchen.

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 395-3554
LICENSING EVALUATOR NAME: Jeremiah RandleTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: OAKMONT OF TORRANCE
FACILITY NUMBER: 198320250
VISIT DATE: 04/05/2022
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Food supply adequate stored in kitchen and consists of the following: Meats, vegetables, fruits, rice, sauces, can goods. Emergency food boxes and emergency water are stored as well.

Smoke Detectors:

Smoke and carbon monoxide detectors throughout the interior facility. Working smoke detectors in all 87 apartment rooms, hallway, and common areas room. Carbon monoxide is attached to the smoke detectors.

Fire clearance:

Fire Clearance with approval on 1/13/22 for a capacity for zero (0) ambulatory, (118 )for non-ambulatory, and (8) for bedridden. Gates have no locks.

Component III:

LPA Johnson conducted the component 3 on 4/5/22 during the Pre-Licensing visit the information provided about how to operate the facility within substantial compliance.

"Pre-Licensing is complete and this facility has no corrections."

Accordingly, LPA Randle will submit a copy of this facility evaluation report to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAU Analyst assigned to their application.

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 395-3554
LICENSING EVALUATOR NAME: Jeremiah RandleTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4