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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602370
Report Date: 10/21/2023
Date Signed: 10/21/2023 05:00:01 PM

Document Has Been Signed on 10/21/2023 05:00 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:HIDDEN VOICES ARFFACILITY NUMBER:
198602370
ADMINISTRATOR:OROSZ, TAMIFACILITY TYPE:
735
ADDRESS:3840 W 180TH PLACETELEPHONE:
(310) 420-0870
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 4CENSUS: 3DATE:
10/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:59 PM
MET WITH:Staff #7TIME COMPLETED:
05:00 PM
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On 10/21/2023 at 2:00:01 pm Licensing Program Analyst (LPA) David España conducted an unannounced 1-year Annual visit to the facility. Upon arriving at the facility, LPA met with Staff #7 (S#7) who assisted with the visit. The purpose of today’s visit was discussed. Upon arrival at the facility, LPA conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection. LPA was granted access and allowed to enter the facility to conduct inspections.

The facility is licensed to operate for four (4) ambulatory adults ages 18 through 59 years of age. The clients are Harbor Regional Center consumers. LPA toured the physical plant. There were no bodies of water or obstructions on the premises. This facility is a one-story facility and has four (4) Bedrooms, two (2) Bathroom, living room, dining area, kitchen, a front and secured back yard. Laundry area is located within the attached garage. Bed linens, comforters, and bath towels were adequately stocked at the visit. The 2 bathrooms were observed and were found to be within required Title 22 regulations and were clean and operational.

LPA inspected and completed a tour alongside the S#7 of the facility, which consists of the following: four (4) client bedrooms which have the required linen supply, including mattress pads, blankets, sheets, bedspreads/comforters. A comfortable temperature of 75 degrees was maintained in the facility. LPA viewed the following to be locked and inaccessible: medications, hygiene supplies, cleaning solutions, toxins, knives, staff and client files. Kitchen has necessary supplies and equipment, including refrigerator, stove, microwave, pots/pans, utensils, cups, plates sufficient for the number of clients served by the facility. The last fire drill was on 09/09/2023. The facility has a working landline telephone. Passageways, hallways and all doors were found to be free from any blocking or obstructions. Designated area for personal hygiene supplies available for clients. Emergency disaster plan, personal rights and complaint procedures are posted. Smoke detectors were found to be operable.
Evaluation Report Continues on LIC 809-C
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: David Espana
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2023
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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: HIDDEN VOICES ARF
FACILITY NUMBER: 198602370
VISIT DATE: 10/21/2023
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LPA observed the hallways and passageways to have sufficient lighting. Pantry for cupboards and utensils and counters are clean. LPA observed sufficient perishable and non-perishable food supplies for the number of clients served. First aid kit was found to be fully stocked. Fire extinguishers were charged, and smoke detectors and carbon monoxide were operable. A review of Medication Records Administration (MAR) and Fire Drills were observed to be maintained in order and accurate. There is a covered area in backyard for client use. The garage is used for storage and for laundry services. S#7 reported that there are no guns or weapons in the home. There are no bodies of water in or around the premises. Water temperature was measured between 105-120 (e.g.,105.9) degrees Fahrenheit.

No deficiencies were cited during this inspection visit, copy of this report provided to facility representative, S #7.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: David Espana
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2023
LIC809 (FAS) - (06/04)
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