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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600085
Report Date: 12/09/2021
Date Signed: 12/09/2021 12:52:18 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/09/2021 12:52 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:
12/09/2021
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Adeshola ObaiyoTIME COMPLETED:
01:10 PM
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Licensing Program Analyst Nicol Wesley conducted an unannounced annual continuation visit and met with staff Precious Ogbechie and Administrator Adeshola Obaiyo on the phone and he allowed staff to assist me with the visit his arrival. The facility phone number is 562 942 1419.

During the visit the Infection control domain was used and the following areas were observed/inspected: The facility had all postings at the front entrance, bathrooms, and throughout the facility. A Pre screening area with PPE supplies was observed upon entry into the facility.

A tour of the entire physical plant was completed, that included: Living room with office area, Kitchen, Dining room, Activity room, 3 Bedrooms, 2 Bathrooms, Garage(washer and dryer), and back yard area(with enclosed patio/shaded area with table and chairs). Food supply was observed, medications, and medication logs were reviewed. The smoke detectors/carbon monoxide detector are operable. LPA observed one fire extinguisher in the kitchen. The water temperature was tested and measured 109.1 degrees F. Mitigation report was approved on 08/06/2021.

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: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2021
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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