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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602219
Report Date: 02/25/2025
Date Signed: 02/25/2025 03:40:57 PM

Document Has Been Signed on 02/25/2025 03:40 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:AMBITIONS - 183RD STREETFACILITY NUMBER:
198602219
ADMINISTRATOR/
DIRECTOR:		ASHILEE JACKSONFACILITY TYPE:
735
ADDRESS:11417 183RD STTELEPHONE:
(562) 219-5799
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY: 3CENSUS: 2DATE:
02/25/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:02 AM
MET WITH:TayVonte WandixTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced case management visit at the facility to gather additional information regarding the elopement of client #1 and met with TayVonte Wandix to discuss the purpose for today's visit. During the visit Administrator Ann Hyde came and joined the visit.

Administrator received a call at 6:30 am, saying client #1 had eloped. They went in to his room to do body checks and client #1 had taken his clothes and some items to make it appear that a body was in the bed. Staff was doing rounds each hour, but don't touch the individuals so they wont disturb them while sleeping. Staff #1 said the last time he physically say client #1 was at 1:30 am when he went to use the restroom. Around 6:30 am, Staff #1 went to the rooms to ask the clients what did they want to eat for breakfast and client #1 didn't answer, so staff #1 went closer to client #1's bed and when he lifted the covers he saw that the client had placed his belonging in the bed to make it appear that he was there. He immediately called the Administrator and they went looking for him at placed they have taken him to, such as the Los Cerritos mall, comic stores, and the library. The Lakewood sheriff was contacted and T. Anderson took a report #025-03101-1348-400 missing person on 02/21/2025,
Client #1 did not previously reside in the area. The Administrator notified the regional
continued on LIC 809C.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Nicol Wesley
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: AMBITIONS - 183RD STREET
FACILITY NUMBER: 198602219
VISIT DATE: 02/25/2025
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center service coordinator, public guardian, and the clients brother and no one have
heard from him. Client #1 had a history of Elopement and self injurious behaviors. While at the facility the client has stolen P&I money and used Client #2 Ipad without permission.

Client #1 was in the hospital waiting for placement from November-February 6th 2025. He aged out from the facility he where he used to reside.
He had broken his arm, and he had stitches from taking a piece tile and cutting his arm.

He came to the facility on February 6th and was missing on February 21st 2025.

The facility had a camera on the east side of the house and client #1, eloped from the west side of the house Client #1 had even taken the electronic brain from the window and door in his room.

Based on the information provided, interviews, and observation, There is no citation issued in accordance to the title 22 regulations or the health and safety code.

Exit interview conducted.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Nicol Wesley
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC809 (FAS) - (06/04)
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