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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601016
Report Date: 03/14/2025
Date Signed: 03/14/2025 05:57:39 PM

Document Has Been Signed on 03/14/2025 05:57 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:AMBITIONS - 184TH PLACEFACILITY NUMBER:
198601016
ADMINISTRATOR/
DIRECTOR:		WALKER, DEMETRAFACILITY TYPE:
735
ADDRESS:3902 W 184TH PLTELEPHONE:
(310) 771-0997
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 4CENSUS: 4DATE:
03/14/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:29 PM
MET WITH:Demetra WalkerTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 03/14/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Case Management Visit to follow up on an incident report that was submitted to the department. LPA met with Administrator, Demetra Walker, and the purpose of today’s visit was explained. LPA was granted entry into the facility.

During today’s visit, LPA interviewed Clients C1-C3, and reviewed Client C1’s Client Progress Notes, Client Profile, Individual Person-Centered Plan, behaviorist report, tracking Behavior Data Collection for fabrication, and Face Sheet

The department received an incident report from the facility regarding C1 having a behavior where bruising occurred. The incident report stated after the behavior a body check was conducted and bruising was observed. Additionally, the department received an incident report from C1’s day program stating C1 said staff at the facility hit her.

During interviews with Client C1- C3, were asked if staff had hit them, three (3) out of three (3) stated they have not been hit by staff. Additionally, two (2) out of three (3) clients stated a client hits the staff when they are protecting them.

No deficiencies were observed or cited.

An exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2025
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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