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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320250
Report Date: 09/09/2022
Date Signed: 09/09/2022 02:21:25 PM


Document Has Been Signed on 09/09/2022 02:21 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: 88DATE:
09/09/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:BELSON, MYLA AdministratorTIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jeremiah Randle arrived unannounced to conduct a Case Management – on 9/9/2022 at 10:25 PM. Upon arrival LPA were greeted at the door by Administrator. Resident census is 88 per administrator. LPA toured facility with Administrator Myla Belson including but not limited to bedrooms of the residents, as well as common areas of the facility. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained throughout the facility. LPA observed the facility to be operational and in good repair. Residents were currently engaged in activities and dining, LPA interviewed Administrator and two Residents.
LPA requested pertinent documents pertaining to the investigation. The following documents were requested: Resident Roster, Staff Roster, Admissions Agreement, Needs and Services Assessment, physicians report, any other pertinent documentation of the residents in question. LPA Advised to Administrator to email documents requested to Jeremiah.Randle@dss.ca.gov.

Further investigation needed and analysis of documentation.
No citations were issued during this visit.
An exit interview was conducted and a copy of this report was provided
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 395-3554
LICENSING EVALUATOR NAME: Jeremiah RandleTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2022
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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