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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601475
Report Date: 12/19/2024
Date Signed: 12/19/2024 12:31:00 PM

Document Has Been Signed on 12/19/2024 12:31 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:EASTER SEALS SOUTHERN CALIFORNIA LA TIJERAFACILITY NUMBER:
198601475
ADMINISTRATOR/
DIRECTOR:		SANKA, DIANE FFACILITY TYPE:
775
ADDRESS:7910 LA TIJERA BLVDTELEPHONE:
(310) 329-1161
CITY:WESTCHESTERSTATE: CAZIP CODE:
90045
CAPACITY: 35CENSUS: 32DATE:
12/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:44 AM
MET WITH:SHAVON STARKSTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 12/19/2024, Licensing Program Analyst (LPA) Antonine Richard conducted a site visit for the 1-year annual inspection, 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. The hot water temperature measured at 112.2F to 114. 1F degrees. 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 of this report was provided to the facility Program

Director Shavon Starks.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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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