198320444-9-12-2025-11-AS-SDAY-DLFQ6J-20250912115337

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198320444
Report Date: 09/12/2025
Date Signed: 09/12/2025 11:53:41 AM

Document Has Been Signed on 09/12/2025 11:53 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:	SOCIAL VOCATIONAL SERVICES., HAWTHORNE INCLUSION C		FACILITY NUMBER:	198320444
ADMINISTRATOR/ DIRECTOR:	CARABANTES, HUGO		FACILITY TYPE:	775
ADDRESS:	14015 HAWTHORNE BLVD.		TELEPHONE:	(310) 944-3303
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY: 45		CENSUS: 9	DATE:	09/12/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:45 AM
MET WITH:	Hugo Carabantes, Program Director		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

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Licensing Program Analyst, Sparkle Day made an unannounced visit to the above facility. The purpose of today's visit was to conduct an annual inspection of the facility. On today's visit LPA met with facility Program Director Hugo Carabantes. The facility profile shows that the facility is licensed for a capacity of (45). The Program Director stated that the facility has (56) clients currently enrolled in the program: (50) ambulatory and (6) non-ambulatory. The staff to client ratio is (1) one staff to (2) two clients. Program Director stated none of the clients have restricted health care conditions or utilize any protective devices. The last disaster drill was conducted 8/22/25 and a Disaster Plan was on file. The last inspection held by the fire department was on 8/08/25. The program does provide transportation. Clients are in the community daily. Day Program hours are 9:00 am - 2:30 pm for clients. Half of this program is community based.

As a part of today's inspection LPA reviewed (10) client records, (5) staff records, (0) Medication Administration Records and inspected the physical plant. This is a day program located in one large building consisting of the following: Parking lot(drop off/pick up area), Lobby area, Quiet room, copy room, Library, Media room, Art room, Computer lab, Kitchen, Storage /Supply room, 5 Offices, 5 bathrooms(men’s, women’s and unisex), and a gated driveway.

LPA conducted a tour of the physical plant and observed the following: walls and floors were in good condition, adequate lighting and fire extinguishers were properly charged. LPA observed plenty of storage space and lockers for clients. All chemicals were properly locked. The restrooms were clean and within Title 22 regulations. The kitchen was clean and a refrigerator was available for client use. The day program does not provide lunch however snacks were available to clients. The first aid kit was available and fully stocked. No clients are taking medication at the facility at time of this visit. Walkways throughout the day program and all exits were clear of hazards and debris.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time.

An exit interview was conducted and a copy of this report was provided to Program Director, Hugo Carabantes,

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Sparkle Day
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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