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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600259
Report Date: 05/09/2025
Date Signed: 05/09/2025 02:12:39 PM

Document Has Been Signed on 05/09/2025 02:12 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
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: 16DATE:
05/09/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:01 AM
MET WITH:Nallely GutierrezTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On May 9, 2025, Licensing Program Analysts Deborah Lee, conducted an unannounced Annual visit to the facility listed above. LPA met with Program Director Nallely Guitierrez, and the purpose of today’s visit was explained. Subsequently, Regional Director Sarafin Avila joined to assist with the visit. The facility is licensed for eighteen (18) adult clients with developmental disabilities. The current census is 16 clients. The program hours are from 9am-3pm.

Physical Plant/Structure:

The two story commercial building consisting of ten (10) rooms, two (2) bathrooms, two (2) activity rooms, kitchen, gym, two (2) offices, computer room, storage room, conference room. Outside grounds were toured and no bodies of water were observed. Multiple (3) shaded areas 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. 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 tested hot water temperature, and it measured at 109.9 degrees Fahrenheit. All walkways inside and outside of the facility were observed to be clean, clear, and free of debris, hazards, and obstructions.

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NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Deborah Lee
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/09/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: SOCIAL VOCATIONAL SERVICES, LB INCLUSION CTR.
FACILITY NUMBER: 198600259
VISIT DATE: 05/09/2025
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Safety:

LPA observed that medication when brought in with clients, they are secured in a locked box in a locked cabinet in the Administrator office and are inaccessible to clients. The last Disaster drill was conducted on 11/ 2024. The last fire inspection was on 3/21/25. The facility is equipped with smoke and carbon monoxide detectors that are operable. LPA observed multiple fully charged fire extinguishers last serviced on 10/23/24 LPA observed and inspected First Aid Kit, and observed it had the required items and a manual. LPA reviewed the Emergency Disaster Plan (LIC610E) for the facility. All entrance/exit doors are marked and accessible. There is a working landline telephone at the facility.

Infection Control During visit, LPAs observed the facilities Infection Control procedures. At the entrance is a sign-in log and a hand sanitizing station. LPA observed Infection Control signs posted in the facility.

Files/Postings LPA reviewed 4 staff files and found that (4) out of (4) contain the required documents, certification, and training. LPA reviewed 5 client files and found (5) out of (5) contained the required documents. LPA observed all required posting including license, personal rights, nondiscrimination policy, “see something, say something,” and activity schedule. During file review, LPA observed all licensing fees are current.

No deficiencies were cited during this visit.

Exit interview conducted and copy of this report was provided to Regional Director Serafin Avila.

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NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Deborah Lee
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2025
LIC809 (FAS) - (06/04)
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