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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600085
Report Date: 10/27/2022
Date Signed: 10/31/2022 08:41:29 AM

Document Has Been Signed on 10/31/2022 08:41 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
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:
10/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Administrator Adeshola Obayo TIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced annual visit focused on Infection Control. LPA met with staff Precious Ogbechie and Administrator Adeshola Obayo arrived shortly after.

As a part of the inspection, LPA used the inspection tool, reviewed (6) client records, (4) staff files, and (5) client medications. Currently the facility has (6) clients which are ambulatory. The facility is vendorized through Eastern Los Angeles Regional Center. 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). Bathrooms were found to be within Title 22 regulation. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Carbon monoxide detector and smoke detectors are operational. Fire extinguishers were fully charged and operational, toxins and knifes were locked and inaccessible to clients. Medications were centrally stored and properly locked, first aid kit was checked an in order. Outside grounds were toured and no bodies of water were observed. Patio furniture with umbrella was accessible. Exits/ Walkways around the home were free of debris and hazards. LPA completed visit with the Inspection Tool focused on Infection Control.

No deficiencies cited on this visit. Exit interview was conducted and a copy of report was furnished
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Jose Villalobos
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2022
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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