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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601422
Report Date: 07/15/2022
Date Signed: 07/15/2022 01:17:47 PM

Document Has Been Signed on 07/15/2022 01:17 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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:CALIFORNIA EMPLOYMENT SUPPORT SERVICES, INC.FACILITY NUMBER:
198601422
ADMINISTRATOR:FRANK AIFUWAFACILITY TYPE:
775
ADDRESS:11144 WASHINGTON BLVDTELEPHONE:
(310) 559-2200
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY: 30CENSUS: 20DATE:
07/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:41 AM
MET WITH:Frank TIME COMPLETED:
01:45 PM
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On 07/15/22, Licensing Program Analysts (LPA) Gail Johnson conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA Johnson met with the Program Coordinator Frank Aifuwa. LPA Johnson explained the purpose of today’s visit. The facility is licensed to serve 30 clients (10 may be non-ambulatory) adults ages 18 and above. Currently, the facility provides service virtual service to 20 clients and (five of them also attend on site activity).

Facility Structure / Physical Plant
LPA Johnson toured the facility structure and physical plant with Administrator Aifuwa. The facility is a one-story structure located in a commercial area. It consists of the following: Main Entry Lobby Area, partitioned computer area, partitioned seating area, lunch area / staff break area, and two (2) bathrooms. There was one (1) parking lot with wheelchair access (drop off/pick up area). There were no bodies of water or obstructions on the premises. Bathroom water temperature measured 106.4 degrees F.

Storage & Inaccessible Items Storage areas for cleaning supplies, toxins, and sharp objects were stored and not accessible to clients. The kitchen was inspected and found as clean and in adequate condition.

Emergency Phone Numbers & Exit Plan: Emergency numbers and the Emergency Disaster Plan are posted on a bulletin board in the main program area. Facility has two (2) land line telephones located in the main program area. A file cabinet held the first aid kit (not expired) and fully supplied with essential items and the manual. Two (2) fire extinguishers were fully charged and three (3) smoke detectors were fully operable.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Gail Johnson
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: CALIFORNIA EMPLOYMENT SUPPORT SERVICES, INC.
FACILITY NUMBER: 198601422
VISIT DATE: 07/15/2022
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Infection Control
During the visit, LPA Johnson observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and clients. Sanitizing stations are in common areas and restrooms. LPA Johnson observed staff was wearing face coverings. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff and resident temperature logs were reviewed. The facility has a Mitigation Plan Report approved by CCLD on file.

Deficincies
Based on the facility tour, the licensee violated the California Code Regulations (CCR) of Title 22 sections 80087 Division 6 Chapter 1. On 07/15/22 (9:47am) LPA Johnson observed On 07/15/22 (9:47am), LPA Johnson observed observed the bathroom sink faucet was in disrepair.

Plan of Correction


Licensee stated that the facility will have the bathroom sink repaired by 07/31/22. This citation must be corrected by POC 07/31/2022.


An exit interview was conducted with Frank Aifuwa. A copy of this report was printed and provided to Frank Aifuwa.

End of report

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Gail Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2