<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601475
Report Date: 12/18/2023
Date Signed: 12/18/2023 11:44:40 AM

Document Has Been Signed on 12/18/2023 11:44 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:EASTER SEALS SOUTHERN CALIFORNIA LA TIJERAFACILITY NUMBER:
198601475
ADMINISTRATOR:SANKA, DIANE FFACILITY TYPE:
775
ADDRESS:7910 LA TIJERA BLVDTELEPHONE:
(310) 329-1161
CITY:WESTCHESTERSTATE: CAZIP CODE:
90045
CAPACITY: 35CENSUS: 21DATE:
12/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Chavon Starks, Program DirectorTIME COMPLETED:
11:50 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Felisa Shirley conducted a site visit for the 1-year annual inspection, with a primary focus on Infection Control measures using the new CARE Inspection Tool. On today’s visit LPA met with facility representative Program Director, Shavon Starks, and the purpose of the visit was explained.


LPA conducted a tour of the facility which includes: Lobby, living room, program offices, three (3) work rooms, one (1) men's bathroom, one (1) ladies’ bathroom, refreshing room, nurse's office, common area, conference room, Media room, computer lab, kitchen, and pantry area. All rooms were complying within title 22 regulations.

LPA observed that licensee is not operating beyond the conditions and limitations specified on the license, including the capacity limitation. Clients are protected against hazards. There are no pools or bodies of water present on the premises. Disinfectants, cleaning solutions, poisons, knives/ sharp objects are inaccessible to clients. The licensee ensures safe and healthy indoor activity space for clients. All fire extinguishers are fully charged.

A comfortable temperature for clients is maintained. Hot water temperature measured at 113 F. All toilets and hand washing facilities are maintained in a safe, sanitary, operating condition. Clients provide their own lunch. Facility has refrigerator, microwave, stove, dishwasher, oven, sink. First Aid Kit was fully stocked, and a manual was available.

No deficiencies were cited during today’s visit.

A copy if this report is being given to the facility representative, Shavon Starks.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2023
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 1