198602202-7-9-2024-11-AS-AINZ-D6ZUPD-20240709154521

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198602202
Report Date: 07/09/2024
Date Signed: 07/09/2024 03:46:11 PM

Document Has Been Signed on 07/09/2024 03:46 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME:	MERIDIAN HOME CARE		FACILITY NUMBER:	198602202
ADMINISTRATOR:	SAN AGUSTIN, JENNIFER G		FACILITY TYPE:	740
ADDRESS:	20526 WOOD AVENUE		TELEPHONE:	(310) 533-7898
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	6	CENSUS: 0	DATE:	07/09/2024
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Joseph Sol/Licensee		TIME COMPLETED:	03:45 PM

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On 7/9/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an announced Case Management visit. Upon arriving at the facility, LPA met with Joseph Sol/Licensee, who assisted with the visit. LPA explained that the purpose of today's visit was to check on the facility after fixing the water break that happened on 9/14/23.

On 9/14/23, RO received a call for a temporary relocation of residents due to a water leak. The administrator stated that half of the facility floors were affected by the water leak, which needs to be repaired, and on 9/25/23, RO received an email from the licensee requesting approval for eviction for all residents. On 9/26/23, LPA visited the facility and inspected the alleged water damage; LPA and administrator toured the entire facility. LPA took pictures of where the water damage occurred. The licensee gave LPA the scope of work from the restoration company. The licensee told LPA he plans to relocate and not evict the residents. The licensee wants to fix the water damage at the facility, and once the restoration is done, he will bring back his residents. The licensee will send a new email to RO stating his relocation plan only.

The evaluation Report continues on the next page, LIC 809-C, providing further details of the inspection findings.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: MERIDIAN HOME CARE	FACILITY NUMBER: 198602202
	VISIT DATE: 07/09/2024

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On 7/9/24, LPA Iniguez and Licensee toured the inside and outside grounds of the facility. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition; adequate lighting and storage for the resident's personal belongings were observed. Bed linens, comforters, and bath towels were adequately stocked during the visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature ranged from 113.5°F to 115.2°F, and the room temperature ranged from 76°F to 78°F.

LPA observed the facility to be sanitary and appropriately furnished during the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and inaccessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was available and maintained adequately.

LPA Iniguez noted that the facility was prepared to welcome residents following today's inspection.

A copy of liability insurance will be email to LPA. Facility Annual Fess current at the time of the visit.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies; therefore, no citations were issued at this time.

An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Licensee / Joseph Sol

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

LIC809 (FAS) - (06/04)

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