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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601591
Report Date: 02/15/2022
Date Signed: 02/15/2022 03:07:15 PM


Document Has Been Signed on 02/15/2022 03:07 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 DR #100
MONTEREY PARK, CA 91754



FACILITY NAME:BENTLEY HOUSEFACILITY NUMBER:
198601591
ADMINISTRATOR:BIOSEH OGBECHIEFACILITY TYPE:
740
ADDRESS:3449 ROSEWOOD AVETELEPHONE:
(213) 478-0800
CITY:LOS ANGELESSTATE: CAZIP CODE:
90066
CAPACITY:6CENSUS: 4DATE:
02/15/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Lilybelle Calzado, Lead StaffTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Ana Soto conducted an unannounced POC visit to the above facility. LPA Soto was met by Lilybelle Calzado, Lead Staff and later spoke with Mona Alcaraz, Administrator via telephone and the purpose of the visit was explained.

LPA Soto interviewed Administrator v ia telephone and interviewed R#1. Toured R#1's room and living room, dining room, and family room. LPA was here to clear POC 87224(a)(4) Eviction Procedures. The licensee may evict a resident...(5). Thirty (30) days written notice to the resident is required...(5).If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463, ... resident. Administrator did not to provide proof of POC correction. The facility was suppose to rescind eviction notice for R#1 and failed to do so by POC due date 02/11/22. Civil penalties have been assessed.

A exit interview conducted with Lilybelle Calzado, Lead Staff and copy of report and appeal rights provided.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana SotoTELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2022
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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