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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600863
Report Date: 07/03/2024
Date Signed: 07/03/2024 12:24:10 PM

Document Has Been Signed on 07/03/2024 12:24 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:EASTER SEALS SOUTHERN CALIFORNIA CARSONFACILITY NUMBER:
198600863
ADMINISTRATOR/
DIRECTOR:		CAREYNAVARRETE, AMBERFACILITY TYPE:
775
ADDRESS:1740 W CARSON STTELEPHONE:
(310) 328-6974
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 18CENSUS: 15DATE:
07/03/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:28 AM
MET WITH:Angel ChristopherTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 07/03/24, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit to the facility listed above. LPA met with Program Director, Angel Christopher, and the purpose of today’s visit was explained. The facility is licensed to serve 18 developmentally disabled clients ages 18 and over approved for 13 non-ambulatory clients. There are currently twenty-six (26) Regional Center clients in placement, ten (10) non-ambulatory, and sixteen (16) ambulatory. There were 8 Clients in the facility during time of visit, and 7 were on a community outing.
Physical Plant/Structure The facility is a single-story commercial building located in a commercial district. The facility consists of the following: a front lounge area, office area, computer area, game room, music/media room, kitchen area, quiet room, refreshing room, two (2) restrooms, and a storage room. In the back LPA observed a shaded area with chairs and a table. LPA did not observe any bodies of water on the premises. All walkway inside and outside of the facility were observed clean, clear, and free of obstructions, debris, and hazards.
Rooms The front lounge area has a large table and chairs for clients to work at. Additionally, there are two (2) couches and a recliner for clients to use and relax. The computer area has four (4) tables with four (4) computers for clients to use. There is an additional lounge area with chairs for clients to relax. The kitchen
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/03/2024
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: EASTER SEALS SOUTHERN CALIFORNIA CARSON
FACILITY NUMBER: 198600863
VISIT DATE: 07/03/2024
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area was observed clean and sanitary. All appliances were observed operational and in good repair. LPA observed food to be labeled, packaged, and stored properly. The facility does not provide snacks or meals to clients, they are available if a client forgets their lunch. The water temperature measured 111.6-degrees Fahrenheit. All knives and sharps are secured in a locked cabinet in a locked storage room. LPA observed three (3) large tables for clients to use for activities or during cooking club. The game room has a table, chairs, and a couch. LPA observed a variety of games available. The music/media room has a table, chairs, and a couch for clients use. LPA observed instruments and other activities available for clients. The refreshing room has a large changing table and a cabinet with supplies for staff. The restrooms were observed to be clean and operational. The safety handrails are secured. The water temperature measured 110.6-degrees and 114.2-degrees Fahrenheit. The facility was kept at a comfortable temperature. All rooms were observed to have ample lighting. The facility was observed to be properly furnished and in good repair.
File Review LPA reviewed the files for four (4) Clients and found they contained the required documents. LPA reviewed the files for the Program Director, and three (3) staff files and found they contained the required documents, training, and certification. LPA reviewed Staff’s CPI cards and observed them to be current. LPA reviewed training logs and logs for in-services that are conducted twice a month. LPA observed required posting, posted throughout the facility.
Medications LPA observed Centrally Stored Medications secured in a locked cabinet in the front lounge area and are inaccessible to Clients. LPA observed medications in their original packaging. Medications are PRN medications and only dispensed when needed.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
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: EASTER SEALS SOUTHERN CALIFORNIA CARSON
FACILITY NUMBER: 198600863
VISIT DATE: 07/03/2024
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Safety LPA observed smoke detectors and carbon monoxide detector are operational. LPA observed four (4) fully charged fire extinguishers, lasted serviced on 09/22/23. The last inspection from the Torrance Fire Department was conducted on 09/22/23. LPA observed the Emergency Disaster Plan posted at the entrance of the facility and in the office area. The last Emergency Drill was conducted on 5/20/24. The facility does have a working landline telephone. LPA inspected the First Aid Kit and observed it had the required items and a current manual. No firearms or ammunition is stored at the facility.
Infection Control Upon entry, LPA observed a sanitizing station that had a visitor log, hand sanitizer and masks available. LPA observed a 30-day supply of Personal Protective Equipment (PPE) secured in a storage room. LPA observed all cleaning supplies secured in a cabinet in a locked storage room. LPA observed an ample supply of paper towel, and hand soap in the storage room. All trash cans were observed with tight fitting lids. LPA observed required Infection Control signs posted throughout the facility.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time.

An exit interview conducted with Program Director, Angel Christopher, and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC809 (FAS) - (06/04)
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