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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600131
Report Date: 01/27/2024
Date Signed: 01/27/2024 12:01:11 PM

Document Has Been Signed on 01/27/2024 12:01 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:CHERONA'S PLACEFACILITY NUMBER:
198600131
ADMINISTRATOR:BRENDA HARRISONFACILITY TYPE:
735
ADDRESS:2907 WEST 138TH STREETTELEPHONE:
(310) 930-2530
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY: 6CENSUS: 4DATE:
01/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Sharron Angela Babb - Licensee/AdministratorTIME COMPLETED:
12:20 PM
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On 1/27/2024 at around 8:30 AM, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Licensee/Administrator Sharron Angela Babb. LPA explained the purpose of the visit and was accompanied by staff inside and outside the facility during this inspection.

This facility is licensed to serve 6 ambulatory adults ages 18 – 59 years.

A total of 4 ambulatory clients are currently residing in this facility.

The facility is a one-story house located in a residential street. The home consists of 3 client bedrooms, 1 client bathroom, 1 staff bathroom, 1 attached garage, 1living/dinning room, 1 kitchen, 1 laundry room, 1 den, and 1 backyard patio area with shaded seating.

Outside grounds were toured and no bodies of water were observed. The patio furniture is under a shaded area and accessible to clients. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises.

LPA toured the kitchen area and observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept in locked storage cabinet.

LPA observed that medications were safe, locked, and inaccessible. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last fire drill was conducted on 12/01/2023. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. There are 2 fire extinguishers in the facility, one is in kitchen area and the other is in the entrance of the facility. The fire extinguishers were last serviced on 10/05/2023.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: CHERONA'S PLACE
FACILITY NUMBER: 198600131
VISIT DATE: 01/27/2024
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3 out of 3 client’s bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly. Adequate lighting and toiletries accessible to clients. LPA tested hot water temperature and it measured between 105 and 120 degrees Fahrenheit. This facility provides clients with hygiene products such as feminine napkins, nonmedicated soap, toilet paper, toothbrush, toothpaste, and comb.

5 staff records were reviewed, 5 out of 5 staff records had current First Aid Certificates, Criminal Record Clearances, Job Applications, Tuberculosis Test, Facility Trainings/Drills, and signed Employee Rights.

5 client records were reviewed and, 5 out of 5 client records had Admission Agreements, Medical Assessments, Consent Forms, Emergency Information, Tuberculosis Test, Centrally Stored Medication Destruction Record, Personal Rights, and Cash Resource Information.

No deficiencies are being cited based on LPA observation, interviews conducted and record review in accordance with the California Code of Regulations, Title 22.

An exit interview was conducted and a copy of this report was left with two staff members.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2024
LIC809 (FAS) - (06/04)
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