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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600404
Report Date: 08/10/2023
Date Signed: 08/11/2023 03:20:09 PM

Document Has Been Signed on 08/11/2023 03:20 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:EASTER SEALS SOUTHERN CALIFORNIA SAN PEDROFACILITY NUMBER:
198600404
ADMINISTRATOR:PRESCOTT, DEEFACILITY TYPE:
775
ADDRESS:1453 W 8TH ST STE ATELEPHONE:
(310) 831-5902
CITY:SAN PEDROSTATE: CAZIP CODE:
90732
CAPACITY: 25CENSUS: 27DATE:
08/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Program Director LaTasha BellardTIME COMPLETED:
11:45 AM
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On 08/10/2023, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit, LPA met with Program Director Latasha Bellard and explained the purpose of today’s visit. The day program is licensed to operate for twenty-five (25) ambulatory developmentally disabled adults ages 18 and above. The consumers are Harbor Regional Center clients except for one (1) consumer that is with North Los Angeles regional center.

The day program is a single-story structure located in a small business plaza. The facility consists of an administrative office, cubicles, lobby area, arts and crafts, living room with a television, computer lab, meeting area, kitchen, dining/work area, conference area, lockers/storage area, storage room, and two (2) coed bathrooms.



As a part of today's inspection LPA reviewed 4 consumer records, 2 staff records and inspected the physical plant, there are no bodies of water or obstructions on the premises. All rooms were inspected and had adequate lighting furnishings. Bathrooms were found to be within Title 22 regulations and were clean and operational. A comfortable temperature was maintained in the facility. LPA observed the day program to be sanitary and appropriately supplied at the time of visit. Sharps and toxins were in the locked storage area and not accessible to consumers. The kitchen was inspected and found all appliances in working condition, consumers bring their own meals.

No medications are given at the site and no consumers with restricted health conditions. There was a fire extinguisher fully charged located near the art room, carbon monoxide and fire detectors observed, last fire drill conducted on 2/27/23. LPA observed a fully stocked first aid kit in the Program Director office.

During today’s visit no discrepancies were observed. Exit interview conducted with Director LaTasha Bellard and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
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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