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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600477
Report Date: 12/05/2023
Date Signed: 12/05/2023 12:08:09 PM

Document Has Been Signed on 12/05/2023 12:08 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: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: 7DATE:
12/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lorna Castro, LicenseeTIME COMPLETED:
12:00 PM
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On 12/05/22, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced annual required visit with a primary focus on Infection Control measures. LPA Felisa met with the Direct Caregiver Rolando Bundalian. LPA explained the purpose of today’s visit. The facility is licensed to operate for (8) ambulatory adults ages 18 through 59. Currently, seven residents reside at this facility.


LPA Shirley and Licensee, Lorna Castro toured the physical plant. 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. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair. 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 at 94.5 F. All fire extinguishers were operable. There are no bodies of water or firearms on the premises.

A comfortable temperature is maintained in the facility. 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 inaccessible to clients. The kitchen was inspected and there is enough perishable and non-perishable food available which is stored properly. Fire extinguishers were charged, smoke detectors and carbon Monoxide were operable. LPA checked first aid kit; and found that it was compliant with a manual.

All mandated inspection control posters were posted. There were no deficiencies found.

Exit interview held. A copy of the report was provided to Licensee Lorna Castro.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2023
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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