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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600775
Report Date: 12/10/2025
Date Signed: 12/10/2025 04:03:17 PM

Document Has Been Signed on 12/10/2025 04:03 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:STRATA BELLA (NORWALK) CORPORATIONFACILITY NUMBER:
198600775
ADMINISTRATOR/
DIRECTOR:		RUDY DEOCAMPOFACILITY TYPE:
735
ADDRESS:13213 FLALLON AVENUETELEPHONE:
(562) 864-9803
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 4CENSUS: 4DATE:
12/10/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Johnette Bellosillo, licenseeTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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A Non-Compliance Conference (NCC) was held at the Monterey Park Adult and Senior Care Program Regional Office. Participants in this meeting included Tony Vasallo (Regional Manager), Fernando Fierros (Licensing Program Manager), Mayra Cota, Elena Mallett, and Cynthia Chan (Licensing Program Analysts), Johnette Bellosillo (Licensee/Administrator), Jon De La Cruz (Administrator), and Mercedes Lowery (Harbor Regional Center).

The purpose of this conference is to discuss the citations issued during an annual inspection held on 9/9/25. The following was discussed:

· Facility does not have an approved fire clearance for the alteration to the garage which is sectioned-off and converted into a room that is currently rented out.


· Capacity is 4; however, there is a renter residing in the additional bedroom in the sectioned off garage.
· Staff did not grant access to a door inside the home which leads into the sectioned-off room.
· Staff not being able to provide proof of criminal background clearance for renter/tenant
· Clarification of administrator for each licensed facility located in Bellflower, Norwalk, and Torrance.
· Administrator did not notify Licensing that she will be away for a period of time.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2025
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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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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: STRATA BELLA (NORWALK) CORPORATION
FACILITY NUMBER: 198600775
VISIT DATE: 12/10/2025
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Pending Plan of Corrections (POCs):

· On 9/9/25, citation issued for section 80010(a) - Limitations on Capacity and Ambulatory Status, where an additional bedroom in the sectioned off garage and was occupied by a tenant, was not cleared. On 9/23/25, a civil penalty of $1,300 was assessed for failure to correct. As of today, POC has not been cleared.


· On 9/9/25, citation issued for section 80086(a) - Alterations to Existing Building or New Facilities, where changes were made to the garage. The POC was not cleared as of today.

Licensee agreed to do the following in order to bring the facility into compliance no later than the following dates:

· Licensee shall submit the plan/correspondence to obtain a permit from the city by 12/11/25.


· A letter is requested to indicate the name, date, and time in which the tenant moved out by 12/11/25.
· The formal request for the change of administrator for Strata Bella (Norwalk) will be submitted to CCL and Regional Center by 12/19/25.
· Licensee will submit a formal letter to Licensing and Regional Center to inform of any future leave of absence for administrator.

An exit interview and a copy of this report was provided to Licensee, Johnette Bellosillo.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025
LIC809 (FAS) - (06/04)
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