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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602392
Report Date: 05/28/2024
Date Signed: 05/28/2024 11:29:56 AM

Document Has Been Signed on 05/28/2024 11:29 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CHOICES R US - STOAKESFACILITY NUMBER:
198602392
ADMINISTRATOR/
DIRECTOR:
MARC SWEETFACILITY TYPE:
735
ADDRESS:9022 STOAKES AVETELEPHONE:
(562) 445-3009
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY: 4CENSUS: 4DATE:
05/28/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:01 AM
MET WITH:John Paul Adeleye (Administrator)TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit at the facility using the CARE Tool. LPA Mora met with John Paul Adeleye (Administrator) and explained the reason for the visit. The facility is licensed to serve 4 ambulatory only clients in the age range of 18 through 59. The facility is operating within the scope of the license.

A tour of the single-story facility included the living room, kitchen, dining area, 4 client bedrooms, 2 bathrooms, laundry area, front yard, backyard, and detached garage. LPA Mora conducted the tour with Mike Johnson and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen. Sharps were observed locked in the medication closet. Chemical and cleaning solutions are kept locked under the kitchen sink. The First Aid kit is kept locked in a kitchen cabinet and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in each bedroom. Dining and living room have sufficient lighting and sitting area. Most medications are kept locked in the medication closet in the hallway. There are some medications kept locked in a kitchen cabinet and a metal box inside the refrigerator. Client files are kept in the medication closet and staff files are kept in the garage. All bedrooms have all required furniture, lighting, and bedding. All bathrooms were observed with shower mats. The water temperature was tested in both bathrooms and measured at 109.7 degrees F which is within the required 105-120 degrees F. A fire extinguisher was observed in the kitchen and it is fully charged. Smoke detectors were observed throughout the facility and in each room and were operable during the visit. There is a carbon monoxide in the laundry area and was operable during the visit. The front yard and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction. LPA reviewed medication for all 4 clients and observed that medications are documented properly and given as prescribed. LPA reviewed files for all 4 clients and 6 staff files and observed no issues. LPA observed administrator certificate for John Paul Adeleye - 6051284735 with an expiration date of 08/06/2025. LPA interviewed 2 staff and 1 client.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report were provided.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Luis Mora
LICENSING EVALUATOR SIGNATURE: DATE: 05/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/28/2024
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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