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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600477
Report Date: 12/29/2021
Date Signed: 12/30/2021 10:53:15 AM

Document Has Been Signed on 12/30/2021 10:53 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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:CAREMORE AID & BOARD FACILITYFACILITY NUMBER:
198600477
ADMINISTRATOR:RONALD F ZABLOCKIFACILITY TYPE:
735
ADDRESS:14807 LEMOLI AVENUETELEPHONE:
(424) 269-1632
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY: 8CENSUS: 8DATE:
12/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Lorna CastroTIME COMPLETED:
12:30 PM
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On 12/29/21, Licensing Program Analysts (LPA) Gail Johnson and Licensing Program Manager (LPM) Eva Alvarez conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA Johnson met with the licensee Lorna Castro. LPA Johnson explained the purpose of today’s visit. The facility is licensed to operate for (8) ambulatory adults ages 18 through 59. Currently, eight residents reside at this facility.

The facility is a one-story structure located in a residential neighborhood. It consists of the following: six (6) bedrooms (one staff bedroom and five client bedrooms) two bathrooms, living area, dining area, kitchen, and outside patio area. LPA Johnson and LPM Alvarez toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for client personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 110.6 F.

Storage areas for personal hygiene, cleaning supplies, toxins, and sharp objects were stored and not accessible to clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available and maintained properly. Two fire extinguishers were charged, smoke detectors and carbon monoxide were operable.

During the visit, LPA Johnson and LPM Alvarez observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA Johnson observed staff was wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff and resident temperature logs were reviewed.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Gail Johnson
LICENSING EVALUATOR SIGNATURE: DATE: 12/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/29/2021
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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: CAREMORE AID & BOARD FACILITY
FACILITY NUMBER: 198600477
VISIT DATE: 12/29/2021
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The facility has a Mitigation Plan Report approved by CCLD on file. No citations were issued during this visit. An exit interview was conducted with Lorna Castro. A copy of this report was printed and provided to Lorna Castro.

End of report

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Gail Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2021
LIC809 (FAS) - (06/04)
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