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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601976
Report Date: 02/01/2024
Date Signed: 02/01/2024 01:59:42 PM


Document Has Been Signed on 02/01/2024 01:59 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:DEL MAR PARKFACILITY NUMBER:
198601976
ADMINISTRATOR:DENISE SUTTONFACILITY TYPE:
740
ADDRESS:990 EAST DEL MAR BOULEVARDTELEPHONE:
(626) 577-0215
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY:60CENSUS: 54DATE:
02/01/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:14 PM
MET WITH:Denise Sutton - Administrator TIME COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA) Mary Flores conducted an unannounced plan of correction (POC) visit to follow up on deficiencies noted during annual visit conducted on 1/4/24.

On 1/4/24 LPA Flores conducted an annual visit and noted the following deficiencies:
Type A - Section 87303(e)(2) Maintenance and Operation: Water temperature tested as follow in RB #222 water temperature tested at 124.0 degrees F., RB#233 tested at 123.4 degrees F., RB 231 tested at 98.8 degrees F., and RB#206 tested at 100.9 degrees F. On 1/5/24 administrator certify in writing that temperature had been adjusted. On 2/1/24 LPA Flores tested water temperate in room #222,233,231, and 206 tested between 107.7- 109.5 degrees F., which is within the required 105-120 degrees F. Deficiency cleared as of 2/1/24.

Type B - Section 87307(d)(2) Personal Accommodations and Services: Courtyard patios were observed with three uneven cracks on the ground of about 1.5 - 2ft in length. On 2/1/24 LPA observed the courtyard and the repairs done to cover the holes. Deficiency cleared as of 2/1/24.

Technical Violations noted:
1) Passage way on the side of the kitchen was observed with a mop bucket, several crates, and a box. On 1/23/24 LPA Flores received pictures of cleared passageways.
2) An evacuation chair at each stairwell. On 2/1/24 LPA observed an evacuation chair in both stairwells.

Exit interview was conducted with Denise Sutton and a copy of this report was provided.
SUPERVISOR'S NAME: Tony VasalloTELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G FloresTELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2024
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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