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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320297
Report Date: 10/10/2022
Date Signed: 10/10/2022 11:41:12 AM

Document Has Been Signed on 10/10/2022 11:41 AM - 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:LIVE LAUGH AND LOVEFACILITY NUMBER:
198320297
ADMINISTRATOR:REED-CHARLES, KEISHAFACILITY TYPE:
735
ADDRESS:100 W BARCLAY STTELEPHONE:
(323) 397-9047
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 6CENSUS: 0DATE:
10/10/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator Keisha Reed-CharlesTIME COMPLETED:
12:00 PM
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On 10/10/2022 around 09:00 AM Licensing Program Analysts (LPA) Jose Calderon and (LPA) Wendy Gibbs conducted an announced face to face visit with administrator Keisha Reed Charles for purpose of a pre-licensing evaluation. The requested capacity is for 6 ambulatory Adult Resident Facility with behavioral issues.

Facility is a 3 bedroom, 3 bathrooms, one-story house. The client bedrooms are spacious and will easily accommodate the client's furnishings. There is a backyard with a covered patio for shade. The patio contained 1 small table and 3 chairs. Outdoor passageways, walkways, driveways, steps and patios are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility. Residents Bedrooms: All 3 Bedrooms are for ambulatory clients. Bedroom’s #1 and #2 and #3 has one bed each client, no chairs, no night stands, no lamps and not enough dressers. Bedrooms #1, #2 and #3 all comply with the requirement of 8 cubic feet of space. Bathroom: Have a working toilet, wash basins, and walk-in shower. Bathroom #1 shower has a grab bars, but the lights do not work. Licensee states bathroom #1 is for ambulatory only residents. Bathroom #2 has a bathtub/shower with grab bars. Bathroom # 3 has a working toilet and sink. LPA observed adequate lighting in hallway leading to bathrooms. Linens & Hygiene Supplies: Beds have the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linen stored in hall closet.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2022
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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: LIVE LAUGH AND LOVE
FACILITY NUMBER: 198320297
VISIT DATE: 10/10/2022
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Emergency Phone Numbers, Exit Plan & Menu: The telephone system is a land line and operable. Emergency Disaster Plan and "See something, say something Let Us Know" were missing. Fire Extinguisher 1 mounted on the wall in hallway next to the kitchen and 1 in the dining room.
Food Service: Dishes, cups and flat ware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery and other sharp kitchen utensils are stored in a locked cabinet located in the kitchen area. Food supply is adequate; stored in kitchen refrigerator and cabinets and consists of the following: A variety of Fresh and Canned fruit, vegetable and meat food items. Smoke Detectors: 4 hard wired smoke detectors are battery and electric. operated & working. Carbon monoxide detector located and mounted in the hallway is operational. Appliances: Gas Stove, oven, microwave, washer, and dryer working. Refrigerator in the kitchen has a measured temperature of at least 37 degrees Fahrenheit for appropriate food storage. Freezer is at 0 zero degrees Fahrenheit. The residence is equipped with central air and heat and each client bedroom is individually climate controlled. Toxins: Locked/stored in the storage room located in the kitchen. Water Temperature: Bathrooms water temperature tested in #1 at 132 F. and #2 132F. and #3 132 F and kitchen 132 F. degrees. Medications, First-Aid Kit & Book: Medication administration records storage area, and first aid kit has been inspected, which are stored in locked kitchen cabinet adjacent the refrigerator, available for staff use but inaccessible to clients.

Clients & Staff Files: Applicant will be handling cash resources of clients and has a surety bond with Nationwide Insurance Company for $3000.00 contract # 7901079185 effective September 16, 2021. Cash resources will be locked and stored with P & I Ledger, accessible to designated staff. Records of staff and clients shall be stored in a locked in staff closet and the section has been inspected.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022
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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: LIVE LAUGH AND LOVE
FACILITY NUMBER: 198320297
VISIT DATE: 10/10/2022
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Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the client's use. LPA did not observe any pet or bodies of water at the facility. LPA did not observe delayed egress, chain locks or dead bolts on exits. LPAs did not observe pad locks or other mechanisms which may be obstructions for safe and quick egress during an emergency on side gates and front exits. Pool/Jacuzzi & Pets: LPA did not observe any pet or bodies of water at the facility. Fire clearance: Fire Clearance was approved on 05/31/2022 for 6 ambulatory clients with no special instructions. LPA did not observe delayed egress, chain locks or dead bolts on exits. LPA did not observe pad locks or other mechanisms which may be obstructions for safe and quick egress during an emergency on side gates and front exits.
During the pre-licensing inspection certain items were observed which do not comply with applicable laws and regulations; the following items must be corrected:

· Bedroom #1, #2 and #3 need chairs, lamps and dressers for each client
· Bathroom #1 lights did not work
· Water temperature in the home measures at 132 F. degrees.
· Signs need posted at entrance ex, if you see something, say something, administrative license, facility license and mitigation plan.
· Cabinet doors in the kitchen need repair.
If additional time is required to complete noted items to correct, then the applicant will request an extension prior to the due date.
Component III: (07/10/2022) about how to operate the facility within substantial compliance was reviewed with licensee.
During the pre-licensing inspection certain items were observed which do not comply with applicable laws and regulations; the following items must be corrected, and proof of correction shall be emailed to LPA Jose Calderon and LPA Wendy Gibbs by 10/14/2022. If additional time is required to complete noted items to correct, then the applicant will request an extension.

An exit interview was conducted, and a copy of this report has been furnished to the applicant via email. Accordingly, LPA Jose Calderon will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022
LIC809 (FAS) - (06/04)
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