198320538-12-16-2024-11-AS-ARID-DBZT98-20241216133132

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198320538
Report Date: 12/16/2024
Date Signed: 12/16/2024 01:31:51 PM

Document Has Been Signed on 12/16/2024 01:31 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:	BEST WAY UNITED LLC		FACILITY NUMBER:	198320538
ADMINISTRATOR/ DIRECTOR:	TAYLOR, CHASITY		FACILITY TYPE:	735
ADDRESS:	10525 RUTHELEN STREET		TELEPHONE:	(323) 440-3446
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90047
CAPACITY: 6		CENSUS: 0	DATE:	12/16/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:14 AM
MET WITH:	Kristal Grundy		TIME VISIT/ INSPECTION COMPLETED:	01:45 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 12/16/2024, Licensing Program Analysts (LPA) Antonine Richard conducted announced visit to this home. LPA was greeted by applicant Kristal Grundy, Chasity Taylor and Gary Ferguson and explained the purpose of today’s pre-licensing inspection visit. An application was submitted to CCLD on 09/09/2024, in the initial license application for an Adult Residential facility. ages 18 years and 59 years old. The applicant requested a capacity of six (6) individuals, and (0) non-ambulatory. Structure: The home consists of five (5) bedrooms, two (2) bathrooms, a one-story home situated in a residential neighborhood. The home includes a living room, family room, dining, kitchen, office, and laundry inside. The living room did not include a fireplace. The living area included recliner seating. Two (2) kitchens, and two (2) refrigerators and two (2) stoves. The rear exterior is fenced throughout. The passageways, walkways, and steps are free from obstructions. Bedrooms Residents: The facility had five (5) bedrooms for residents. There are five (5) bedrooms for ambulatory, and one (1) bedroom specific for the couple. Three (3) rooms include a twin-size bed, two (2) rooms include full size beds, one (1) chair, one (1) nightstand, and one (1) table lamp and one (1) dresser. All bedrooms are equipped with recessed lights. All rooms had a dresser, which complies with the requirement of 8 cubic feet of space. All rooms had closets for ample storage. The room also included recessed ceiling lights. Evaluation Report Continues

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

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 4

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: BEST WAY UNITED LLC	FACILITY NUMBER: 198320538
	VISIT DATE: 12/16/2024

NARRATIVE

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Bedrooms Staff:
No bedroom is designated for live-in staff.

Bathrooms:
The home has two (2) bathrooms. The bathroom has a working toilet, washbasin, and shower with grab bars and non-skid mats.

Linens & Hygiene Supplies:
Beds have the required linen supplies which include, pillowcases, mattress pads, fitted sheets, blankets, and bedspreads. An adequate supply of linen is stored in the office closet.

Emergency Phone Numbers, Exit Plan & Menu:
Emergency phone numbers. The exit plan and menu are posted and readily available for review throughout the home. There are two (2) fire extinguishers located in the kitchen (1) in the hallway by the laundry room. A telephone line is available in the office, living, and family room. Emergency supplies and Personal Protective Equipment supplies are stored in the hallway. The applicant has an approved Infection Control Plan on file.

Food Service:
Dishes, cups, and flatware are stored in the kitchen cabinets, inspected, and in good repair. Knives, cutlery, and other sharp kitchen utensils are stored in a locked kitchen drawer. Food supply is adequately stored in kitchen cabinets and consists of the can goods. The kitchen counters also had small appliances.

Smoke Detectors:
Smoke and carbon monoxide detectors throughout the interior space. Hardwired smoke detectors in all five (5) bedrooms, hallways, family room, and the office.

Toxins:
All toxins are locked and stored under the kitchen sink cabinet and the laundry room cabinet.

Evaluation Report Continues

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BEST WAY UNITED LLC	FACILITY NUMBER: 198320538
	VISIT DATE: 12/16/2024

NARRATIVE

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Appliances:
Stove burners, oven, washer, and dryer are working. The kitchen counters also had small appliances which includes toaster, and coffee maker. There is two (2) refrigerators in the home. The refrigerators measured a temperature of at least 40 degrees Fahrenheit for appropriate food storage. The home with electric fans and heaters. The living area has a heating system.

Water Temperature:
The water temperature is 120.1F degrees throughout the kitchen and bathrooms.

Medications, First-Aid Kit & Book:
A first aid kit is stored in the medication cabinet inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and current first aid manual locked and inaccessible to residents. The resident's medications will be stored in a mental cabinet locked in the hallway room area and inaccessible to residents.

Resident & Staff Files:
The applicant will be handling the cash resources for residents. Records of staff and residents will be stored in a cabinet in the office room area.

Reading Material, Games, Equipment & Materials:
The facility has board games, books, magazines, and other recreational materials for the resident's use stored in the family room.

Pool/Jacuzzi & Pets:
There are no pets, jacuzzi, or pool in the fenced area.

Evaluation Report Continues

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: BEST WAY UNITED LLC	FACILITY NUMBER: 198320538
	VISIT DATE: 12/16/2024

NARRATIVE

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Fire clearance:
A Fire Clearance inspection was conducted on 08/29/2024 approved for a capacity for six (6) ambulatory, and zero (0) no ambulatory.

Component III:
LPA Richard conducted the Pre-Licensing inspection along with the information provided about how to operate the facility within substantial compliance with Component III Power Point.

LPA Richard did not observe any deficiencies.

An exit interview was conducted, and a copy of this report has been furnished to the applicant Kristal Grundy. LPA Richard will submit a copy of this facility evaluation report to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAU Analyst assigned to their application.

END OF REPORT

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

LIC809 (FAS) - (06/04)

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