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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600085
Report Date: 10/15/2021
Date Signed: 12/09/2021 04:45:09 PM

Document Has Been Signed on 12/09/2021 04:45 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CHOICES R US - WOODHUEFACILITY NUMBER:
198600085
ADMINISTRATOR:BRADFORD, SHAJUANAFACILITY TYPE:
735
ADDRESS:9523 WOODHUE STTELEPHONE:
(562) 942-1419
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 6CENSUS: 6DATE:
10/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Loyce OhiaTIME COMPLETED:
04:30 PM
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Licensing Program Analyst Nicol Wesley conducted an unannounced Required 1 year inspection at the facility and met with staff Loyce Ohia and explained the purpose for todays visit. Prior to the visit LPA Wesley conducted a risk assessment for on-site inspections. LPA Wesley spoke to Administrator Adeshola Obayo on the phone and he allowed staff to assist me with the visit his arrival. The facility phone number is 562 942 1419.

The facility consist of 3 client bedrooms, 2 bathrooms, living room, dining room, kitchen and garage. Mitigation report was reviewed and approved on 08/06/2021. There were no immediate health and safety concerns observed.

Due to time constraints, LPA will return on a later date to complete the inspection.




There were no deficiencies cited. A copy of this report was issued during the exit interview.
SUPERVISORS NAME: Rebecca Orendain
LICENSING EVALUATOR NAME: Nicol Wesley
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2021
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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