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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320390
Report Date: 03/19/2025
Date Signed: 03/19/2025 01:29:07 PM

Document Has Been Signed on 03/19/2025 01:29 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:PERSON CENTERED OPTIONS IIFACILITY NUMBER:
198320390
ADMINISTRATOR/
DIRECTOR:		THOMPSON, TIKIFACILITY TYPE:
735
ADDRESS:1402 E. WASHINGTON STREETTELEPHONE:
(909) 904-2913
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 3CENSUS: 3DATE:
03/19/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:01 PM
MET WITH:Administrator Monique Weatherspoon TIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 03/19/25 Licensing Program Analyst (LPA) Villegas conducted a case management visit to clear deficiencies cited during annual inspection. LPA met with Administrator as the purpose of the visit was explained. During the case management visit LPA conducted a review of (2) staff files, (3) client files, (3) P&I ledgers, and conducted a tour of the facility to ensure nights lights are in hallways and passages to non-private bathrooms. LPA observe both deficiencies cited on 07/31/24 to be corrected.

Exit interview conducted with Administrator Monique Weatherspoon, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2025
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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