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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600722
Report Date: 10/07/2022
Date Signed: 10/07/2022 02:51:39 PM

Document Has Been Signed on 10/07/2022 02:51 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:UNLIMITED SOLUTIONSFACILITY NUMBER:
198600722
ADMINISTRATOR:HECTOR NAVARROFACILITY TYPE:
735
ADDRESS:25151 ESHELMAN AVETELEPHONE:
(310) 784-0750
CITY:LOMITASTATE: CAZIP CODE:
90717
CAPACITY: 4CENSUS: 4DATE:
10/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:24 PM
MET WITH:House Manager - Lilia Delacruz/Administrator Ana "Patty" NavarroTIME COMPLETED:
03:00 PM
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On 10/07/2022, Licensing Program Analyst (LPA) Don Senaha conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with House Manager Lilia Delacruz and was later joined by Administrator Ana "Patty" Navarro and explained the purpose of today’s visit. The facility is licensed to operate for four (4) developmentally disabled clients between the ages of 18 through 59 of which one (1) can be a non-ambulatory client.


The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) client rooms, one (1) staff room, one (1) office space, two (2) bathrooms with one (1) of those bathrooms being in the staff room, a living area, a dining area and kitchen. There is an outside patio area with ample seating and an umbrella used for shade. The washer and dryer is located in the hallway near the rear rooms. The garage is attached with access from the front of the garage and a side door directly inside the front door. Garage is used for storage only.

LPA and House Manager 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 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 met Title 22 standards in the bathrooms and kitchen sink measuring between 108.1 F and 109.1 F. A comfortable temperature was maintained in the facility.


Evaluation Report Continues on LIC 809-C
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Don Senaha
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2022
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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: UNLIMITED SOLUTIONS
FACILITY NUMBER: 198600722
VISIT DATE: 10/07/2022
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LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning solutions, toxins and sharps 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. There is one (1) fire extinguisher fully charge located in the laundry area. Smoke detectors and carbon monoxide were operable and in working condition. A reviewed of Medication Records Administration (MAR) was observed to be maintained in order and accurate.

During the visit, LPA observed the facility infection control practices. LPA observed hand sanitizer available and temperature taken upon entry to the facility. There is a first aid kit in the office. LPA observed two (2) clients present and two (2) clients were at the Day Program at the time of the visit, with all four (4) clients being Harbor Regional Center clients.

There were no deficiencies cited during this inspection visit.

There were no technical advisories given.

An exit interview was conducted and a copy of this report was provided to Administrator Ana “Patty” Navarro.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Don Senaha
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC809 (FAS) - (06/04)
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