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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320315
Report Date: 10/22/2024
Date Signed: 10/22/2024 11:41:10 AM

Document Has Been Signed on 10/22/2024 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:BAY TOWERS AT BIXBY KNOLLSFACILITY NUMBER:
198320315
ADMINISTRATOR/
DIRECTOR:		MCDONALD, DONFACILITY TYPE:
740
ADDRESS:3747 ATLANTIC AVENUETELEPHONE:
(562) 426-6123
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 65CENSUS: 37DATE:
10/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:18 AM
MET WITH:Marylou Escobedo & Donald McDonaldTIME VISIT/
INSPECTION COMPLETED:
11:12 AM
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On 10/22/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced Case Management visit at this facility. LPA was greeted by Resident Service Director Marylou Escobedo. LPA explained the purpose of this visit was to inspect the facility.

3747 Atlantic Avenue, Long Beach, CA 90807 is a six-story structure building located in a commercial neighborhood. It consists of the following: a lobby area, a dining area, administrative offices, public restrooms, a prep kitchen, storage rooms, activity rooms, an employee lounge, a laundry room, linen closets, medication rooms, hand wash station, (57) resident bedrooms, and (57) resident bathrooms and occupies the first, fourth , fifth, and sixth floors for Assisted Living licensed by Community Care Licensing (CCL). Designated floors of 2nd and 3rd floors are for Post Acute Care is licensed by the Department of Health.

First Floor:
The main floor is composed of the following: (1) Lobby, (3) Administrative Offices, (1) Staff Office Room, (1) Dining/Activities area, Resident Mailboxes, (1) Prep Kitchen, (3) Public Restrooms, (1) Staff Restroom, (1) Storage Closet, (2) elevators, and an outside patio area.

Fourth Floor:
The assisted living floor consisted of the following: Residents individual private rooms #401-#420, (1) Family Room, (1) Charting Room, (1) Administrative Office, (1) Medication Room, (1) Medical Records Room, (1) Trash Chute, (1) Staff Restroom, (1) Linen Closet, (1) Hand Wash Area, (2) Elevators, and (2) Emergency Staircases.

(Evaluation Report continues on LIC 809-C)
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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 2
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: BAY TOWERS AT BIXBY KNOLLS
FACILITY NUMBER: 198320315
VISIT DATE: 10/22/2024
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Fifth Floor:
The assisted living floor consisted of the following: Residents individual private rooms #501-#520, (1) Activity Room, (1) Activity Office, (1) Seating Area, (2) Linen Closets, (1) Trash Chute, (1) Staff Restroom, (1) Storage Closet (2) Elevators, and (2) Emergency Staircases.

Sixth Floor:
The assisted living floor consisted of the following: Residents individual private rooms #601-#620, (1) Sitting Area (1) Linen Closet, (1) Laundry Room, (1) Staff Restroom, (1) Employee Lounge, (1) Storage Closet, (1) Trash Chute, (2) Elevators, and (2) Emergency Staircases.

The main commercial kitchen being utilized by assisted living is located at 3737 Atlantic Avenue Long Beach, CA 90807 directly across 3747 Atlantic Avenue Long Beach, CA 90807. The commercial kitchen is located in Building A and is not licensed by Community Care Licensing (CCL). The Bay Towers at Bixby Knolls are required to submit a Request for Waiver Submission for Kitchen Use.

In total, there are two buildings on the property lot separated by a parking lot. Building A is for Independent Living 3737 Atlantic Avenue and Building B is the Assisted Living and Post Acute 3747 Atlantic Avenue.

An exit interview is conducted with Marylou Escobedo, and a copy of the report is provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
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