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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600259
Report Date: 04/22/2024
Date Signed: 04/22/2024 02:49:50 PM

Document Has Been Signed on 04/22/2024 02:49 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:SOCIAL VOCATIONAL SERVICES, LB INCLUSION CTR.FACILITY NUMBER:
198600259
ADMINISTRATOR/
DIRECTOR:		SERAFIN AVILAFACILITY TYPE:
775
ADDRESS:530 EAST WARDLOW ROADTELEPHONE:
(562) 424-7322
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 18CENSUS: 18DATE:
04/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:24 AM
MET WITH:Administrator Serafin AvilaTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On 04/22/2024 at 8:24 AM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with the Administrator Serafin Avila and Program Director Nallely Gutierrez. LPA explained the purpose of the visit and were accompanied by Program Director inside and outside the facility during this inspection.

The one-story facility consisting of three (3) activity rooms, kitchen, gym, two (2) offices, computer room, storage room, conference room, two (2) bathrooms .

The facility is licensed for eighteen (18) adult clients with developmental disabilities.

Outside grounds were toured and no bodies of water were observed. Multiple (3) shaded areas are was accessible to clients. Walkways around the program was clear of hazards. There are no security bars or weapons on the premises.

All rooms were checked. and are in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair. All equipment, computers, workstations are well maintained and there is adequately PPE stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were not accessible to clients. Kitchen was inspected and observed to be clean and operational. LPA Cloyd tested hot water temperature and it measured at 112.5 degrees Fahrenheit.

LPA observed that Medications were safe, locked and inaccessible. Documents are posted as mandated. Last Disaster drill was conducted on February 2024. First aid kit is fully stocked. The last fire inspection was on May 3, 2023 and the facility is in compliance.



Continue to LIC809-C.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE: DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2024
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 5
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: SOCIAL VOCATIONAL SERVICES, LB INCLUSION CTR.
FACILITY NUMBER: 198600259
VISIT DATE: 04/22/2024
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Five (5) staff records were reviewed. Two staff members were interviewed.

Five (5) client records were reviewed and, 5 out of 5 client records had Medical Assessments, and Needs & Services Plans/IPP. Three clients were interviewed. Two client medications were reviewed.

No deficiencies cited.

An exit interview was conducted and technical assistance provided. A copy of this report was discussed and left with the Administrator and Program Director.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024
LIC809 (FAS) - (06/04)
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