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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600562
Report Date: 06/27/2026
Date Signed: 06/27/2026 01:59:51 PM

Document Has Been Signed on 06/27/2026 01:59 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:BIANCA RESIDENTIAL CAREFACILITY NUMBER:
198600562
ADMINISTRATOR/
DIRECTOR:		HARRISON, JANICEFACILITY TYPE:
735
ADDRESS:4600 WEST 166TH STREETTELEPHONE:
(310) 370-2924
CITY:LAWNDALESTATE: CAZIP CODE:
90260
CAPACITY: 4CENSUS: 4DATE:
06/27/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:35 AM
MET WITH:Janice Harrison - AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced, met with Administrator Janice Harrison, and explained the purpose for today’s visit. The facility is licensed to serve 2 Ambulatory and 2 Non-Ambulatory adults ages 18-59.

The facility is a single-story home located in a residential area in Lawndale, Ca. A tour of the facility includes: 4 client bedrooms, 1 full bathroom, 2 1/2 bathrooms (located in client bedrooms), living room, dining area, kitchen, laundry room, front yard and attached garage.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:


Infection Control: The facility maintains the required Infection Control Plan on site.
Physical Plant & Environment Safety: LPA toured facility, clients’ bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was tested in the client bathrooms and was not within the required range of 105-120 degrees F, client 1/2 baths and the main full bathroom water temperature measured between 95.8-98.8 degrees F, citation issued. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to clients. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged.
Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables.
Operational Requirements: Facility has an activity area furnished for outdoor use. (Continued on LIC 809-C)
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2026
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
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: BIANCA RESIDENTIAL CARE
FACILITY NUMBER: 198600562
VISIT DATE: 06/27/2026
NARRATIVE
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Staffing & Personnel Records-Training: There appears to be sufficient staffing at all times in the facility. Staff files are maintained in a secure location. LPA was not able to review staff files during today’s visit as all files were locked in the file cabinet and there was no key available to open it to access the files, Technical Violation issued. Janice Harrison maintains a valid certificate that expires 6/25/2028.
Client Rights-Information: Facility provides telephone landline and internet for the clients. Client rights posters and reporting posters are displayed within the facility.
Client Records-Incident Reports: Client files are maintained in a secured locked location and were not accessible during visit as Administrator did not have the key to the locked file cabinet, citation issued.
Health Related Service: Medication is properly labeled and are centrally stored in a locked cabinet and are in their original containers. During Medication Review, LPA observed 1 missed AM medication for today 6/27/26, the medication was able to be administered as it was still within the 4-6 hour window frame to be administered, this was a multi vitamin medication that is non-life threatening, Technical Violation issued.
Incidental Medical & Dental: All training is documented in the facility personnel files.
Disaster Preparedness: LPA was not able to review the emergency disaster plan or the emergency drill logs during visit as all files were locked in the file cabinet and Administrator did not have a key to open the cabinet to access files, citation issued.
Emergency Intervention: Clients at this facility do not need the use of restraints or de-escalation techniques.

Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during todays visit will be detailed on the attached LIC809-D page.

Exit interview was held and a copy of the report, Appeal Rights and Technical Violations, were provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2026
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 06/27/2026 01:59 PM - It Cannot Be Edited


Created By: Tena Herrera On 06/27/2026 at 01:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BIANCA RESIDENTIAL CARE
FACILITY NUMBER: 198600562

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80088(e)(1)
Fixtures, Furniture, Equipment, and Supplies
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as during facility tour the water temperature was measured in client 1/2 baths and main full bath, water temp measured between 95.8-98.8 degrees F, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/03/2026
Plan of Correction
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During visit Administrator called plumber to repair water heater, plumber arrived during visit.
Administrator/Licensee to create a water temperature log for the next 3 consecutive days beginning morning of 6/28/26 and ending evening of 6/30/26, water is to be tested 3 times a day, and temperature is to be recorded on the log morning, day, evening and must read within the required range. the water temperature log is to be emailed to LPA by POC due date. tena.herrera@dss.ca.gov
Type B
Section Cited
CCR
80070(d)
Client Records
(d) All client records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and attempted record review, the licensee did not comply with the section cited above as all client records/files were locked in a file cabinet and Administrator did not have a copy of the key to access the files, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/03/2026
Plan of Correction
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Administrator/Licensee to develop a plan on how they will ensure files will be accessible to licensing during future inspections/audits, this plan is to be emailed to LPA by POC due date. tena.herrera@dss.ca.gov
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
David Sicairos
NAME OF LICENSING PROGRAM MANAGER:
Tena Herrera
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2026


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 06/27/2026 01:59 PM - It Cannot Be Edited


Created By: Tena Herrera On 06/27/2026 at 01:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BIANCA RESIDENTIAL CARE
FACILITY NUMBER: 198600562

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1565(a)
Other Provisions
(a) A facility shall have an emergency and disaster plan that shall include, but not be limited to, all of the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and attempted record review, the licensee did not comply with the section cited above as the emergency disaster plan and emergency drill logs were stored in a locked file cabinet, administrator did not have the key to access the files within the file cabinet, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/03/2026
Plan of Correction
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Administrator/Licensee to email a copy of the Emerrgency disaster plan and the last 3 emergency drill logs to LPA by POC due date. tena.herrera@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
David Sicairos
NAME OF LICENSING PROGRAM MANAGER:
Tena Herrera
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2026


LIC809 (FAS) - (06/04)
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