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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601429
Report Date: 01/15/2025
Date Signed: 01/15/2025 01:29:56 PM

Document Has Been Signed on 01/15/2025 01:29 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:CHOICES R US - WARDFACILITY NUMBER:
198601429
ADMINISTRATOR/
DIRECTOR:		GILBERT CARDENASFACILITY TYPE:
735
ADDRESS:2100 WARD AVETELEPHONE:
(562) 445-3009
CITY:COMPTONSTATE: CAZIP CODE:
90221
CAPACITY: 3CENSUS: 3DATE:
01/15/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:12 AM
MET WITH:Administrator Gilbert CardenasTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
NARRATIVE
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On 01/15/25, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Administrator Gilbert Cardenas as the purpose of the visit was explained. The facility is licensed to serve 3 developmentally disabled adults ages 18-59 of which 1 may be non-ambulatory. Current census is 3, clients are linked to the South Central Los Angeles Regional Center. Facility fees are current.

The facility is a single-story structure located in a residential neighborhood and consists of the following: (3) client bedrooms, 1 and a half bathroom, living room, kitchen, dining area, an attached garage with washer and dryer, storage area, emergency food and water supply. There is a fenced backyard a shaded patio area, and a shed used for additional storage. LPA observed the following during inspection of client rooms: mattresses and box springs in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. LPA observed fully stocked bedding and towel closet. LPA observed bathrooms were found to be within Title 22 regulation. All bathroom fixtures are clean, in good repair, and working properly. LPA observed sufficient bedding, linens, and toiletries are accessible to clients. The water temperature properly measured between 105-120 F.. (2) fire extinguishes were observed to be charge, last fire drill conducted on 11/05/24. Carbon monoxide and smoke detectors observed to be operational, land line and internet service was observed. No weapons nor bodies of water on the premises. Facility has an active surety bond .

LPA conducted a records review of 2 staff records, 3 client records, and 3 medication administration records, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked.

Deficiencies observed were cited on 809D page.

Exit interview conducted, appeal rights explained, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/15/2025
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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Document Has Been Signed on 01/15/2025 01:29 PM - It Cannot Be Edited


Created By: Lizeth Villegas On 01/15/2025 at 12:23 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: CHOICES R US - WARD
FACILITY NUMBER: 198601429

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80026(h)(1)
Safeguards for Cash Resources, Personal Property, and Valuables of Residents
Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following:

Records of clients' cash resources maintained as a drawing account, which shall include a current ledger accounting, with columns for income, disbursements and balance, for each client. Supporting receipts for purchases shall be filed in chronological order.


Deficient Practice Statement
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Based on [(observation) and (interview) the licensee did not comply with the section cited above AS P&I ledgers for client 1-Client 3 were not available at the time of visit which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/29/2025
Plan of Correction
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Licensee and/or Administrator to ensure all P&I ledgers are up to date and at the facility at all times. Copies of P&I ledgers to be sent to LPA by POC due date.
Type B
Section Cited
CCR
80087(c)
Buildings and grounds
All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard shall be kept free of obstruction.

Deficient Practice Statement
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Based on [(observation) the licensee did not comply with the section cited above As LPA observed (2) big tires as well as old furniture in the backyard which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/29/2025
Plan of Correction
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Licensee and or Administrator to ensure all open areas are free of obstruction by removing the items observed. Licensee and or Administrator to send LPA proof of correction by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Janae Hammond
LICENSING EVALUATOR NAME:Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:
DATE: 01/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/15/2025


LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 01/15/2025 01:29 PM - It Cannot Be Edited


Created By: Lizeth Villegas On 01/15/2025 at 01:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: CHOICES R US - WARD
FACILITY NUMBER: 198601429

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80076(a)(17)
Food Services
In facilities providing meals to clients, the following shall apply:

All kitchen, food preparation, and storage areas shall be kept clean, free of litter and rubbish, and measures shall be taken to keep all such areas free of rodents, and other vermin.

Deficient Practice Statement
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Based on [(observation) the licensee did not comply with the section cited above as kitchen cabnets are stained and are not sanitary which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/29/2025
Plan of Correction
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Licensee and/or Administrator will ensure all kitchen areas that house perishable and non-perishable foods are cleaned and sanitary at all times. Proof of correction to be sent to LPA by POC due date.
Type B
Section Cited
CCR
85088(c)(2)(e)(2)
Fixtures, Furniture, Equipment and Supplies
The licensee shall ensure provision to each client of the following furniture, equipment and supplies necessary for personal care and maintenance of personal hygiene.
Bedroom furniture including, in addition to (c)(1) above, for each client, a chair, a night stand, and a lamp or lights necessary for reading.

Emergency lighting, which shall include at a minimum working flashlights or other battery-powered lighting, shall be maintained and readily available in areas accessible to clients and staff.
Night lights shall be maintained in hallways and passages to nonprivate bathrooms.


Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above as LPA did not observed all the required furniture in bedroom 1,2, and 3. LPA also did not observe night lights in the hallway and passage to nonprivate bathrooms which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/29/2025
Plan of Correction
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Licensee and/or Administrator to make corrections and send LPA proof of corrections by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Janae Hammond
LICENSING EVALUATOR NAME:Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:
DATE: 01/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/15/2025


LIC809 (FAS) - (06/04)
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