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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320276
Report Date: 07/11/2024
Date Signed: 07/11/2024 02:53:14 PM

Document Has Been Signed on 07/11/2024 02:53 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:EMBRACE RESIDENTIAL HOMES INC.FACILITY NUMBER:
198320276
ADMINISTRATOR/
DIRECTOR:
WASHINGTON, CARMITA; LEWISFACILITY TYPE:
735
ADDRESS:14818 SOUTH BUTLER AVETELEPHONE:
(424) 785-8202
CITY:COMPTONSTATE: CAZIP CODE:
90221
CAPACITY: 4CENSUS: 4DATE:
07/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:39 PM
MET WITH:Licensee Craig LewisTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 07/11/24, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Licensee Craig Lewis as the purpose of the visit was explained. The facility is licensed to serve (4) ambulatory develop disabled adults ages 18-59. The current census is (4), clients are linked to the South Central Regional Center. Facility fees are current.

The facility is a single-story structure located in a residential neighborhood and consists of the following: Living room, kitchen with a dinning area, (4) client bedrooms, (3) restrooms, (1) staff office, a large den, a laundry area, a patio with shaded seating, and an outdoor storage 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, there is a side by side refrigerator and freezer, and an additional freezer chest. LPA observed toxins and knifes to be 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 3 staff records, 2 client records, and 2 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 06/01/24, 2 fire extinguisher fully charged and mounted, carbon monoxide and smoke detectors are interconnected and operational. LPA observed the facility to be a great condition, very clean and sanitary at the time of inspection.

Exit interview conducted with Licensee Craig Lewis, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2024
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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