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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600746
Report Date: 10/18/2023
Date Signed: 10/18/2023 01:04:57 PM

Document Has Been Signed on 10/18/2023 01:04 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:SVS- TORRANCE INCLUSION CENTERFACILITY NUMBER:
198600746
ADMINISTRATOR:LESLY PADILLAFACILITY TYPE:
775
ADDRESS:3535 TORRANCE BLVD SUITE 6-10TELEPHONE:
(310) 944-3303
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY: 18CENSUS: 14DATE:
10/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Janet MadrigalTIME COMPLETED:
01:20 PM
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On 10/18/2023, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA met with Program Director Janet Madrigal and explained the purpose of today’s visit.

The facility is licensed to serve developmentally disabled clients 18 years and above, approved for (6) non-ambulatory clients only.

LPA toured the facility with Program Director Janet Madrigal. LPA inspected the Receptionist area, Program Director's office, quiet room/clients locker room, staff storage/locker, leisure room, fitness room, client's locker corner, arts and crafts room, kitchen, computer room, case manager's room, staff break room, and three (3) bathrooms. All areas are clean, safe, sanitary and in good repair. Each room is equipped and furnished to ensure the comfort and safety of all persons in the day program.

Documents are posted as mandated. The most recent Disaster Drill was conducted on 02/28/2023 The program’s current activity schedules are posted. There is a 3 to 1 or 6 to 2 clients to staff ratio.

The Adult Day Program is located in a small business plaza, and program hours are from 8:30 AM to 2:00 PM, and 3:00 PM- 7:00 PM, Monday through Friday. Some clients bring their own lunch or cash to purchase food near the facility. Program Director stated that if clients forget their lunch the facility will provide food for lunch and inform the residential home or client's family.

LPA observed the Hot water temperature measured at 106.4F and 109.3F degrees Fahrenheit in clients bathrooms#2 and #3.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SVS- TORRANCE INCLUSION CENTER
FACILITY NUMBER: 198600746
VISIT DATE: 10/18/2023
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Program Director Janet Madrigal tested eight smoke detectors in the hallway and are operable, fire extinguishers are fully charged last service on 03/15/2023, rest-rooms are clean and operational, toxic/sharp items locked inaccessible to clients. Hazardous items are inaccessible to clients and first aid kit is fully stocked. The day programs grounds are free of debris, hazards and obstructions.

During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols staff and visitors, and sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The facility has an approved Mitigation Plan Report on file with CCLD. The facility's annual fee is current.

No deficiencies are being cited during today's visit.

An exit interview was conducted, a copy of this report was given to Program Director Janet Madrigal.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
LIC809 (FAS) - (06/04)
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