198602032-1-18-2024-11-AS-RCLD-CZLW2V-20240118155458

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198602032
Report Date: 01/18/2024
Date Signed: 01/18/2024 03:55:02 PM

Document Has Been Signed on 01/18/2024 03:55 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
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	FINEST LIVING GUEST HOME II		FACILITY NUMBER:	198602032
ADMINISTRATOR:	MEDINA, MARGARITA		FACILITY TYPE:	740
ADDRESS:	2104 W. 230TH STREET		TELEPHONE:	(310) 533-7343
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90501
CAPACITY:	6	CENSUS: 5	DATE:	01/18/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Teresa Guanlao		TIME COMPLETED:	04:15 PM

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On 01/18/2024 at 2:10 PM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced Required – Annual Inspection and met with Dina Paras. Administrator Teresa Guanlao joined us later. Five (5) residents and two (2) staff were present during this inspection.

Facility is licensed to serve facility licensed to serve six (6) non-ambulatory residents over 60 years old. The facility is approved for six (6) hospice residents. The facility currently has one hospice resident.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) bedrooms of which two (2) are private rooms and two (2) are shared rooms, 2 bathrooms, a living area, dining area, kitchen, and outside covered patio area.

Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed.

Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises.

Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked.

Continued to LIC809-C

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: FINEST LIVING GUEST HOME II	FACILITY NUMBER: 198602032
	VISIT DATE: 01/18/2024

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Common areas were clean and clear of hazards.

LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxics were kept in locked storage cabinet.

Staff tested carbon monoxide detectors and smoke detector located near the kitchen area. Both devices were functional.

5 resident records were reviewed.

Due to time constraints, LPA Cloyd was unable to finish the inspection. Technical assistance was provided and a copy of this report was left with the Administrator Teresa Guanlao.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

LIC809 (FAS) - (06/04)

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