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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600746
Report Date: 08/15/2024
Date Signed: 08/15/2024 12:48:42 PM

Document Has Been Signed on 08/15/2024 12:48 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/
DIRECTOR:		LESLY PADILLAFACILITY TYPE:
775
ADDRESS:3535 TORRANCE BLVD SUITE 6-10TELEPHONE:
(310) 944-3303
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY: 18CENSUS: 61DATE:
08/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Nalleli Robledo, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 08/15/2024 at around 8:00 AM, Licensing Program Analysts (LPAs) Leandro and Enriquez conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Program Director, Nalleli Robledo. LPAs explained the purpose of the visit and was accompanied by Program Director inside and outside the facility during this inspection.

This facility is licensed to serve 18 adults ages 18 – 59 years of which 6 may be non-ambulatory clients.

The Annual Licensing Fees are current.

The facility is a one-story commercial building located on a main street. The facility consists of a conference room, art room, computer room, leisure room, fitness room, reception area, program director office, break room, case manager office/conference room, kitchen, quiet room, 4 storage rooms, 4 bathrooms and a parking lot.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
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: 08/15/2024
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Walkways around the building were clear of hazards. There are no security bars or weapons on the premises. LPAs toured the kitchen area and observed knives and toxins were kept in locked storage cabinet. There are landline phones on the premises and video conferencing devices dedicated for client use.

Documents are posted as mandated. Last Fire Drill was conducted on 08/08/2024 and last Earthquake Drill was conducted on 02/29/2024. The facility had their Annual Fire Inspection on 12/15/2023. First aid kit is fully stocked with manual. There are several fire extinguishers on the premises, and they were last serviced on 10/15/2023.

5 staff records were reviewed and, 5 out of 5 staff records had required documentation.

5 client records were reviewed and, 5 out of 5 client records had required documentation.

No deficiencies are being cited based on LPAs observation and record review in accordance with the California Code of Regulations, Title 22.

An exit interview was conducted. A copy of this report is being provided to the Program Director.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC809 (FAS) - (06/04)
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