198601536-6-28-2023-11-AS-FSHY-CT8UA7-20230628152416

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198601536
Report Date: 06/28/2023
Date Signed: 06/28/2023 03:24:25 PM

Document Has Been Signed on 06/28/2023 03:24 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	JOHN AND MARVELLA'S OASIS RCF		FACILITY NUMBER:	198601536
ADMINISTRATOR:	MYKIYAA WALKER-SANCHEZ		FACILITY TYPE:	735
ADDRESS:	142 E ALLENHURST STREET		TELEPHONE:	(310) 817-4211
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90061
CAPACITY: 4		CENSUS:	DATE:	06/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:21 PM
MET WITH:	Mykiyaa Walker		TIME COMPLETED:	03:30 PM

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Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced Annual required visit with a primary focus on infection control measures. LPA was met by Mykiyaa Walker, Administrator and the purpose of today’s visit was explained. The facility is licensed to serve 4 developmentally disabled clients (age 18-59). Today’s census is 3.

This facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 2 bathrooms, dining room, kitchen, living room, and front and backyards.

The 2 bedrooms contained 2 beds, dresser, nightstand, chairs, ample lighting and closet space. The third room is designated as an office.

LPA walked through the kitchen and all appliances were in good working order. Knives were locked in the kitchen and inaccessible to residents. LPA observed a 3-day supply of perishable and a 7-day supply of nonperishable foods. The water temperature measured 114.3 degrees Fahrenheit.

All bathrooms were checked, sufficient liquid soap and paper towels were observed. Toilets and water faucets worked properly. The walk-in showers were free of mildew and mold. LPA walked through the garage where the washer and dryer were and all cleaning products were locked in a cabinet and inaccessible dto residents.

All rooms and walkways were clean, and clear of obstructions and hazards. All areas have ample lighting. All rooms, and hallway have working smoke detectors. Carbon monoxide detector was functional. There is a fully charged fire extinguisher in the dining room.

con'd on 809-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: JOHN AND MARVELLA'S OASIS RCF	FACILITY NUMBER: 198601536
	VISIT DATE: 06/28/2023

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LPA walked the outside of the facility. LPA observed an enclosed shaded patio area. All walkways were clear of debris, obstructions and hazards. LPA did not observe any bodies of water.

No deficiencies were cited during this visit.

An exit interview was conducted, and a copy of this report provided to administrator.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

LIC809 (FAS) - (06/04)

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