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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601422
Report Date: 06/12/2024
Date Signed: 06/12/2024 11:34:40 AM

Document Has Been Signed on 06/12/2024 11:34 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:CALIFORNIA EMPLOYMENT SUPPORT SERVICES, INC.FACILITY NUMBER:
198601422
ADMINISTRATOR/
DIRECTOR:		FRANK AIFUWAFACILITY TYPE:
775
ADDRESS:11144 WASHINGTON BLVDTELEPHONE:
(310) 559-2200
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY: 30CENSUS: 26DATE:
06/12/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:47 AM
MET WITH:Frank Aifuwa/Program DirectorTIME VISIT/
INSPECTION COMPLETED:
11:34 AM
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On 6/12/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Frank Aifuwa /Program Director. The facility profile shows that the facility is licensed for a capacity of (30) Developmentally Disable Adults of which (10) can be non-ambulatory. The program director stated that the facility has (26) clients enrolled in the program. The staff-to-client ratio is (3) to (1). The Program Director noted that the facility has (0) clients with a Restricted Health Care condition. Currently, there are (0) clients using protective or assisted devices. Clients are from Westside and South Central Regional Center.

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).

The LPA and Program Director toured the entire facility. LPA found that the inside areas are free of hazards and obstructions. The restrooms have working toilets and wash basins that can accommodate non-ambulatory clients in wheelchairs. Emergency phone numbers are posted and readily available for review in the activity area. The fire extinguishers are up to fire code, and the facility's telephone system is working correctly.

The evaluation Report continues on the next page, LIC 809-C, providing further details of the inspection findings.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: CALIFORNIA EMPLOYMENT SUPPORT SERVICES, INC.
FACILITY NUMBER: 198601422
VISIT DATE: 06/12/2024
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The bathrooms were found to be within Title 22 regulations, clean, and operational. The water temperature correctly measures between 105°F and 120°F: bathroom #1 was at 115.2°F, bathroom #2 was at 117.3°F. A comfortable temperature is maintained throughout the facility. Smoke detectors and carbon monoxide alarm systems worked properly. The facility is equipped with central air. All knives and poisons were kept locked at the time of the visit.

As a part of today's inspection, LPA reviewed (4) client records, (4) staff records. All records were appropriately maintained.

A first aid kit has been inspected, with at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and the current first aid manual. These items are stored in locked steel drawers, available for staff use but inaccessible to clients. The facility conducted a fire drill on 5/31/24, and a Disaster Plan was on file. The program does not provide transportation.

The facility does not handle clients' cash resources or manage clients' medications. Facility Annual Fees not Current, LPA shared this information with Program Director and provided him PIN number: 024119.

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


An exit interview was conducted, and Frank Aifuwa, the Program Director, received a copy of the Facility Evaluation Report.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
LIC809 (FAS) - (06/04)
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