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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601492
Report Date: 01/23/2025
Date Signed: 01/23/2025 07:33:22 PM

Document Has Been Signed on 01/23/2025 07:33 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:BEGINNINGSFACILITY NUMBER:
198601492
ADMINISTRATOR/
DIRECTOR:		HOLLAND, TRAVISFACILITY TYPE:
735
ADDRESS:1112 BASELINE RDTELEPHONE:
(909) 305-0250
CITY:LA VERNESTATE: CAZIP CODE:
91750
CAPACITY: 3CENSUS: 2DATE:
01/23/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:22 AM
MET WITH:Administrator- Travis HollandTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required Visit on 1/23/2025. LPA Ramirez was met by Administrator Travis Holland and explained the purpose of the visit. The facility is approved for two (2) ambulatory and one (1) non-ambulatory developmentally disabled adults, ages 18-59. There are currently 2 clients residing in this facility and receive case management services provided by San Gabriel/Pomona Regional Center.

LPA OBSERVATIONS: The facility is a single-story dwelling located on a main street. The facility consists of three (3) client bedrooms, two (2) bathrooms, kitchen, dining room, living room, front yard, backyard and attached garage.

Front Yard: LPA Ramirez observed front yard to be free of hazards. Front yard was well maintained.

Kitchen: LPA Ramirez observed appliances to be in working order. LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed a fully charged fire extinguisher nearby. Kitchen sink temperature was measured at 114.6-degree F. LPA Ramirez observed facility menu on refrigerator.

Dining Room/Living room: Dining room was observed to contain one table with two (2) chairs. Living room was observed to contain plenty of lighting. LPA Ramirez observed a fully charged fire extinguisher nearby. LPA Ramirez observed signage promoting cough and hand washing etiquette in this area.

Linen Closet/Supply Closet: Observed to contain plenty linens, towels, and hygiene products.

See 809-C

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: BEGINNINGS
FACILITY NUMBER: 198601492
VISIT DATE: 01/23/2025
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Client Rooms 1 - 3: LPA Ramirez observed client bedrooms#1-3 to contain the required linens, furnishings, and lighting. Client bedroom#1 is currently unoccupied.

Bathroom 1-2: LPA Ramirez observed nonslip mats in bathrooms showers. LPA Ramirez observed signage promoting proper handwashing etiquette near sink. Water temperature in bathroom#1 was measured at 114.8 degree F. Bathroom#2 located in client bedroom#2, water temperature was measured at 114.8 degree F.

Backyard: No large bodies of water were observed.

Emergency Drills: Last documented disaster drill was conducted on 1/15/25.

Carbon Monoxide Detectors/Fire Alarm/Fire Extinguisher & Emergency Disaster Plan: LPA observed carbon monoxide and smoke detectors in hallways. Smoke detectors were observed to be operable during visit.

Personnel Records: LPA Ramirez reviewed three (3) personnel records. LPA Ramirez observed required annual training, CPR and First Aid for three, and CPI Training for (3) out of the three (3) personnel records reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for three (3) out of the three (3) personnel records reviewed. Administrator Certificate for Travis Holland expires 07/31/2025. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.


Client Files: Client files were maintained at facility. LPA Ramirez reviewed two (2) resident records.

Infection Control Plan: Facility has current infection control plan.

Exit interview was conducted. No deficiencies were cited. A copy of this report was provided via email.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
LIC809 (FAS) - (06/04)
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