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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601731
Report Date: 09/17/2021
Date Signed: 09/17/2021 11:10:37 AM

Document Has Been Signed on 09/17/2021 11:10 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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME:EASTER SEALS SOUTHERN CALIFORNIA CRENSHAWFACILITY NUMBER:
198601731
ADMINISTRATOR:DANKA, DIANE FFACILITY TYPE:
775
ADDRESS:14800 CRENSHAW BLVDTELEPHONE:
(310) 329-1161
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY: 35CENSUS: 0DATE:
09/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Angel Chrisopher-EvansTIME COMPLETED:
11:15 AM
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On 9/17/2021, Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced annual required visit with a primary focus on Infection Control measures. LPA met with Program Director Angel Christopher-Evans and explained the purpose of today’s visit. The facility is licensed for thirty-five (35) ambulatory clients of which twenty-five (25) may be non-ambulatory.

The Day program is a single-story structure located in a commercial building. Facility grounds consist of the following: Reception area/lobby, kitchen, 3 restrooms, 3 offices, multi-purpose room, arts and crafts room, activity room, media lounge area, changing room, storage room. Common areas such as bathrooms and classrooms were observed to be neat, clean, and properly furnished.

LPA and Program Director Angel Christopher-Evans toured the physical plant. There were no bodies of water or obstructions on the premises. Bathrooms were found to be within Title 22 regulations and were clean and operational.

LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. Fire extinguishers are fully charged.

During the visit, LPA observed the facility infection control practices. LPA observed screening protocol for visitors, staff, and clients, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted.

No deficiencies were cited during this inspection visit.

An exit interview was conducted, and a hard copy of this report was provided to Program Director Angel Christopher Evans via email.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2021
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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