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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602370
Report Date: 06/14/2024
Date Signed: 06/14/2024 03:10:10 PM

Document Has Been Signed on 06/14/2024 03:10 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:HIDDEN VOICES ARFFACILITY NUMBER:
198602370
ADMINISTRATOR/
DIRECTOR:		OROSZ, TAMIFACILITY TYPE:
735
ADDRESS:3840 W 180TH PLACETELEPHONE:
(310) 420-0870
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 4CENSUS: 3DATE:
06/14/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:22 PM
MET WITH:TrinaMarie HarrisonTIME VISIT/
INSPECTION COMPLETED:
02:59 PM
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On 06/14/24, Licensing Program Analysts (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with House Manager TrinaMarie Harrison. LPA explained the purpose of today’s visit. The facility is licensed to operate for (4) ambulatory adults ages 18 through 59. The residents are all Harbor Regional Center consumers.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: (4) residents' rooms, (2) bathrooms, a living area, a dining area, a kitchen, an outside seating area, and a garage used for storage .

LPA toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 107.4 degrees F. A comfortable temperature of 73 F. degrees was maintained in the facility.

LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. A fire extinguisher was charged. A review of the Medication Records Administration (MAR) was observed to be maintained in place.

During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted.
(Evaluation Report continues LIC 809-C)
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2024
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: HIDDEN VOICES ARF
FACILITY NUMBER: 198602370
VISIT DATE: 06/14/2024
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LPA observed First Aid Kit was maintained. A working landline phone was operational. The last fire drill was conducted on 07/0723. The facility had operational smoke and carbon monoxide in bedrooms and common areas. The facility has current liability insurance on file effective and a Surety Bond.

An audit of clients #1-#3 (C1-C3) service files and staff #1-#4 (S1-S4) personnel files revealed to be complete. Interviews were not available for clients as they were all out in the community. The facility has the current Administrator's Certification on file for TrinaMarie Harrison #6062902735 Exp. 01/30/25. The facility is current with CCL annual dues.

No deficiencies during this inspection visit.

An exit interview was conducted with Trina Marie Harrison a copy of the report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
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