198601375-1-23-2025-11-AS-PSCT-DD7Q2M-20250123104722

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198601375
Report Date: 01/23/2025
Date Signed: 01/23/2025 10:47:27 AM

Document Has Been Signed on 01/23/2025 10:47 AM - 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME:	CATO Q CARE ARBUTUS		FACILITY NUMBER:	198601375
ADMINISTRATOR/ DIRECTOR:	PAMELA CATO		FACILITY TYPE:	735
ADDRESS:	1354 W. ARBUTUS ST.		TELEPHONE:	(310) 604-0189
CITY:	COMPTON	STATE: CA	ZIP CODE:	90220
CAPACITY: 4		CENSUS: 3	DATE:	01/23/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Pamela Cato		TIME VISIT/ INSPECTION COMPLETED:	11:15 AM

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On 1/23/25, at 9:00am, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced visit to CATO Q CARE ARBUTUS. The purpose of today’s visit was to conduct the required annual inspection, using the new Care Tool. LPA was met by Pamela Cato, Administrator, and the purpose of today’s visit was explained. The facility is licensed to serve four (4) ambulatory Developmentally Disabled Clients (age 18-59). Currently, the home has (3) ambulatory clients. The clients are South Central Los Angeles Regional Center clients. None of the clients have Restricted Health Care Conditions and none utilizes postural supports or protective devices. The facilities’ annual fees are current.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: two (2) client bedrooms, one (1) bathroom, living room, dining area, kitchen, indoor and outdoor activity area, laundry room and garage.

LPA conducted a records review of (3) client records, (4) staff records, (3) client Personal & Incidental Records and reviewed the facility disaster plan. All client & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (3) Client Medication Administration Records and did not observe any discrepancies at the time of visit.

At 9:30am, LPA and the administrator toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, adequate storage for client personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly. The shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature measured 106.8F in the bathroom and 108.1F in the kitchen. A comfortable temperature is maintained in the facility. The last emergency fire drill was last performed on 01/08/2025.

Facility Evaluation Report Continued On LIC809-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: CATO Q CARE ARBUTUS	FACILITY NUMBER: 198601375
	VISIT DATE: 01/23/2025

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LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is enough perishable and non-perishable food available, which is stored properly. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual. The fire extinguisher was charged and last inspected on 11/01/2023. Smoke/ Carbon Monoxide detectors were operable. The facility has current liability insurance, and it expires on 01/25/2025. The administrator has a valid administrator’s certificate which expires on 10/23/2025.

During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA further observed the facility to have a 30-day supply of Personal Protective Equipment (PPE).

LPA advised the administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues.

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 was held, and a copy of the Facility Evaluation Report was provided to Pamela Cato, Administrator.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

LIC809 (FAS) - (06/04)

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