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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602078
Report Date: 11/18/2024
Date Signed: 11/18/2024 02:54:04 PM

Document Has Been Signed on 11/18/2024 02:54 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:CARING HOUSEFACILITY NUMBER:
198602078
ADMINISTRATOR/
DIRECTOR:		STEPHANY HARLOWFACILITY TYPE:
740
ADDRESS:2842 EL DORADO STREETTELEPHONE:
(310) 796-6625
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
11/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Administrator - Joanna FrancoTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On 11/18/2024, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) staff conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Administrator, Joanna Franco. CCLD staff explained the purpose of the visit and was accompanied by a staff member inside and outside the facility during this inspection.

The facility is licensed to serve 6 adults ages 60 and above, of which 6 maybe bedridden and 6 maybe on hospice.

The facility currently has 4 residents.

The Annual Licensing Fees are current.

The facility is a one-story house located in a residential street. The home consists of 6 resident bedrooms, 2 full bathrooms, 1 toilet room, 1 living room area, 1 dining room area, 1 kitchen area, 1 small office area, 1 conference room, 1 attached garage with a laundry area and an office area, and 1 backyard patio area with shaded seating.
Ulysses CoronelTELEPHONE: (323) 981-1755
Socorro LeandroTELEPHONE: 323-981-1755
DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2024
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 3
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: CARING HOUSE
FACILITY NUMBER: 198602078
VISIT DATE: 11/18/2024
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The facility has supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept in locked storage cabinet.

Medications were safe, locked, and inaccessible. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last Earthquake and Disaster drill was conducted on 10/17/2024. There is a fire extinguisher in the kitchen area, and it was last serviced on 07/16/2024. There are landline telephones on the premises. There is a videoconferencing device dedicated for client use in the hallway area next to the resident bedrooms.

6 out of 6 residential bedrooms were checked. There is adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Bathroom toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. This facility provides residents with hygiene products such as feminine napkins, nonmedicated soap, toilet paper, toothbrush, toothpaste, and comb.
SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro LeandroTELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CARING HOUSE
FACILITY NUMBER: 198602078
VISIT DATE: 11/18/2024
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Currently, there is construction happening on the premises. The facility is getting a new roof. Construction began on 11/18/2024 and it is expected to finish on 11/21/2024. The facility has a Notice of Construction and Safety on their front door providing detailed information of the construction work. The facility has written a safety plan for the construction. There is a safety worker that is assisting people to get in and out of the facility. Due to the construction, the walkways around the facility were not clear of hazards.

5 resident records were reviewed and, 5 out of 5 resident records had required documentation.

CCLD staff were unable to review staff records due to unforeseen circumstances. A technical violation is being issued. The licensee has agreed to create a plan to always have access to their staff records.

No deficiencies are being cited based on LPA observation and record review in accordance with the California Code of Regulations, Title 22.

An exit interview was conducted, and a copy of this report was left with the Administrator.
SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro LeandroTELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2024
LIC809 (FAS) - (06/04)
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