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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601493
Report Date: 08/30/2024
Date Signed: 08/30/2024 09:06:23 AM

Document Has Been Signed on 08/30/2024 09:06 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:GMS ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
198601493
ADMINISTRATOR/
DIRECTOR:		CHRISTOPHER SORTOFACILITY TYPE:
735
ADDRESS:18322 SUBIDO STREETTELEPHONE:
(626) 820-9387
CITY:ROWLAND HEIGHTSSTATE: CAZIP CODE:
91748
CAPACITY: 6CENSUS: 4DATE:
08/30/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:12 AM
MET WITH:DSP Blanca NunoTIME VISIT/
INSPECTION COMPLETED:
09:10 AM
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Licensing Program Analyst (LPA) Christian Gutierrez conducted a plan of correction (POC) visit and met with DSP Blanca Nuno at approximately 8:05 AM and explained the reason for the visit. Administrator Christopher Sorto was contacted by phone.

On 08/02/2024 LPA was conducting annual inspection and cited for the following deficiency’s:

80066(a)(12)(B)1 (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator, and each employee. Each personnel record shall contain the following information: (12) For employees that are required to be fingerprinted pursuant to Section 80019: (B) Documentation of either a criminal record clearance or exemption as required by Section 80019(e). 1. For Certified Administrators, a copy of their current and valid Administrator Certification meets this requirement.

POC were due on 08/16/2024 and as of today 8/30/2024 the facility has not cleared POC’s. LPA will be assessing civil penalties a copy of report and 421M was given to DSP Blanca Nuno.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2024
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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