198320315-5-18-2024-11-AS-SLEO-D5DRNR-20240518131045

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198320315
Report Date: 05/18/2024
Date Signed: 05/18/2024 01:10:57 PM

Document Has Been Signed on 05/18/2024 01:10 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	BAY TOWERS AT BIXBY KNOLLS		FACILITY NUMBER:	198320315
ADMINISTRATOR:	MCDONALD, DON		FACILITY TYPE:	740
ADDRESS:	3747 ATLANTIC AVENUE		TELEPHONE:	(562) 426-6123
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90807
CAPACITY:	65	CENSUS: 35	DATE:	05/18/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Residents Services Director - Mary Lou Escobedo		TIME COMPLETED:	01:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/18/2024 at around 8:40 AM, Licensing Program Analyst (LPA), Leandro conducted an unannounced Required – 1 Year Inspection to Bay Towers at Bixby Knolls facility and met with the Residents Services Director, MaryLou Escobedo. LPA explained the purpose of the visit and was accompanied by the Resident Services Director inside and outside the facility during this inspection. The facility’s former name was Bixby Knolls Tower, facility number: 191601645, effective date: 5/16/1993. Current facility name Bay Towers at Bixby Knolls, Facility Number: 198320315, Effective Date: 9/5/2023. This facility is licensed to serve 65 non-ambulatory adults ages 60 and above. The facility is a 6-story commercial building located on a main street. The building consist of consists of 57 resident bedrooms, 57 resident bathrooms, 12 common bathrooms, dining room, commercial kitchen, staff room, media rooms, office area, washer and dryer/storage area, backyard with umbrella with table and chairs.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BAY TOWERS AT BIXBY KNOLLS	FACILITY NUMBER: 198320315
	VISIT DATE: 05/18/2024

NARRATIVE

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Outside grounds were toured and no bodies of water were observed. The patio furniture is under a shaded area and accessible to residents. Walkways around the facility were clear of hazards. There is maintenance happening on the premises and the City of Long Beach Bureau of Environmental Health Department of Health & Human Services has inspected the facility.

LPA toured the kitchen area and observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept in locked storage cabinet.

LPA observed that medications were safe, locked, and inaccessible. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last Disaster drill was conducted in April 2024. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. There was an inspection performed on 10/16/2023 on the signal systems, fire alarms, fire sprinklers, elevators, etc.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BAY TOWERS AT BIXBY KNOLLS	FACILITY NUMBER: 198320315
	VISIT DATE: 05/18/2024

NARRATIVE

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Several residents’ bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. LPA tested hot water temperature and it measured between 105 and 120 degrees Fahrenheit. This facility provides residents with hygiene products such as feminine napkins, nonmedicated soap, toilet paper, toothbrush, toothpaste, and comb.

5 staff records were reviewed, 5 out of 5 staff records had required Criminal Record Clearances. 5 resident records were reviewed and, 5 out of 5 resident records had required documentation.

No deficiencies are being cited based on LPA observation, interviews conducted and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted and a copy of this report was left with the Residents Services Director.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2024

LIC809 (FAS) - (06/04)

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