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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601587
Report Date: 10/28/2022
Date Signed: 10/28/2022 02:27:26 PM

Document Has Been Signed on 10/28/2022 02:27 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CHOICES R US - ZAMORAFACILITY NUMBER:
198601587
ADMINISTRATOR:LASHON JOHNSONFACILITY TYPE:
735
ADDRESS:10524 E ZAMORA AVETELEPHONE:
(562) 445-3009
CITY:LOS ANGELESSTATE: CAZIP CODE:
90002
CAPACITY: 4CENSUS: 3DATE:
10/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:14 PM
MET WITH:Lashon Johnson, AdministratorTIME COMPLETED:
02:35 PM
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Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with DSP staff Unique Johnson and explained the purpose of the visit. Administrator Lashon Johnson arrived shortly after. There are currently three (3) non- ambulatory disabled clients ages of 18 through 59 serviced by South Central Los Angeles Regional Center Community Placement Program (CPP). The facility is a single story home located in a residential neighborhood. It consists of 4 client bedrooms, 2 bathrooms, kitchen, dining area, living room, outdoor patio, and detached garage. The last fire/emergency drill was conducted on 9/1/2022. Administrator certificate expires 5/24/2024.

OBSERVATIONS:
  • The interior and exterior physical plant was inspected. The facility is equipped with a fire pull alarm system. Smoke and carbon monoxide detectors were tested and operational.
  • COVID-19 Infection Control Practices and signs that promote hand washing, cough/sneeze etiquette, and physical distancing were observed in the entrance, common areas, hallways, bathrooms and client rooms. There is a screening station at the entrance of the facility to screen visitors.
  • Each client room is designated as a COVID-19 isolation room if needed.
  • A posted Emergency Disaster Plan was observed.
  • Centrally stored medications/30-day supply of medications were observed.
  • Staff were observed wearing mask. Clients do not wear masks due to disability exemption.
  • The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food.
  • Water temperature was within normal limits 105 degrees Fahrenheit (40.5 degrees C) and not more than 120 degrees Fahrenheit (48.8 degrees C).
  • Facility has an adequate 30-day+ supply of Personal Protective Equipment (PPEs).
  • The facility submitted a COVID-19 Mitigation Plan. An Infection Control Plan (ICP) has not been submitted.
  • Submit the ICP as soon as possible. The plan should be reviewed and updated as necessary.
No deficiencies were cited. A technical assistance advisory note was issued.
Exit interview was conducted with Administrator Lashon Johnson. A copy of the report was issued.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2022
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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