<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601778
Report Date: 07/27/2022
Date Signed: 07/27/2022 01:45:52 PM


Document Has Been Signed on 07/27/2022 01:45 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:BROOKDALE UPTOWN WHITTIERFACILITY NUMBER:
198601778
ADMINISTRATOR:MAGPAY, PRECIOSA (SUZIE)FACILITY TYPE:
740
ADDRESS:13250 E PHILADELPHIA STTELEPHONE:
(562) 945-3904
CITY:WHITTIERSTATE: CAZIP CODE:
90601
CAPACITY:280CENSUS: 122DATE:
07/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Suzie Preciosa Magpayo (Administrator)TIME COMPLETED:
02:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Kruz Long conducted an unannounced visit to the facility to conduct an Annual Inspection. Upon arrival, LPA met with Suzie Preciosa Magpayo (Administrator) and explained the purpose of the visit.

The facility is licensed for: 280 NON-AMBULATORY RESIDENTS AGES 60 AND OVER. MAY RETAIN EIGHT HOSPICE RESIDENTS.

During today's inspection, LPA observed the following: Facility is not operating over capacity or beyond any conditions and limitation on the license. Facilities maintains in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. No ammunition or firearms on the premises. Facility maintains a comfortable temperature for residents. All outdoor and indoor passageways are free of obstruction. The presence of grab bars for each toilet, bathtub and shower used by residents was observed. Bathtub or shower have non-skid mats or strips. Beds have the required linen/supplies which include pillowcase, mattress pads, fitted sheet, blanket and bed spreads. Adequate supply of linens and hygiene supplies are readily available. Facilities have a signal system that operates from each resident’s living unit. Hot water temperature measured between 105 degrees F and 120 degrees F in various bathrooms. Minimum of one week supply of nonperishable foods and 2 days of perishable foods was observed. All readily perishable foods or beverages capable of growth of micro-organisms is stored in covered containers at appropriate temperature. Smoke and Carbon Monoxide detectors are operable. The facility has sufficient and competent staff to provide the services needed to meet resident needs. A first aid kit has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, first aid manual available for staff use. Staff assisting residents with ADLs have required training. LPA reviewed 10 Staff records and observed Staff to have criminal record clearance. Staff responsible for direct care and supervision have current first aid training. 10 Resident records reviewed with updated emergency contacts. Facility have a disaster and mass casualty plan. Employees of CCLD is allowed to enter the facility to conduct inspections. A certified Administrator is on the premise for a sufficient number of hours to manage and oversee the business operation. Medications is given per the physician’s directions. Centrally stored medicines is kept in a safe and locked place.

No deficiencies were observed during today's visit.

An exit interview was conducted and a copy of this report was provided to Suzie Preciosa Magpayo.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Kruz LongTELEPHONE: (323) 383-8117
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1