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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602413
Report Date: 11/22/2024
Date Signed: 11/22/2024 11:44:46 AM

Document Has Been Signed on 11/22/2024 11:44 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:LA'DELIA RESIDENTIAL HOMEFACILITY NUMBER:
198602413
ADMINISTRATOR/
DIRECTOR:		OIKHALA, PERPETUALFACILITY TYPE:
735
ADDRESS:7023 DENVER AVETELEPHONE:
(323) 305-1971
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY: 4CENSUS: 2DATE:
11/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:06 AM
MET WITH:PERPETUAL OIKHALA - ADMINISTRATORTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 11/22/2024, Licensing Program Analyst (LPA) Troy Watson made, and unannounced inspection visit to La ‘Delia Residential Home, for the required annual inspection, using the new CARE Inspection Tool. On today’s visit LPA met with Perpetual Oikhala, the Administrator, and the purpose of the visit was explained. The facilities annual fees are current. The facility has a capacity for four (4) clients. Currently, the home has 2 ambulatory clients, and none have a restricted health care condition, and all clients are between the ages of 18-59.

LPA Troy Watson toured the inside and outside of the facility with the Administrator Perpetual Oikhala and the (2) clients’ rooms were checked. Mattresses and box springs were in good condition, clean and in good repair. Adequate lighting, chairs and lamps were present working and in good condition. There was plenty of dresser and closet space in each client’s bedroom.

Bed linens, comforters and bath towels were adequately stocked at the time of visit. The bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly. The bathtub was free of mold/mildew. The water temperature properly measured between 109 F and in the bathroom and in the kitchen.

Evaluation Report continues LIC 809-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024
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: LA'DELIA RESIDENTIAL HOME
FACILITY NUMBER: 198602413
VISIT DATE: 11/22/2024
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LPA Troy Watson observed the facility clean, sanitary, and appropriately furnished at the time of the visit. The kitchen, and refrigerators was fully stocked with food. The facility has (6) smoke detectors / carbon monoxide detectors that have been tested and found operational. The facility also had 2 current and fully charged fire extinguishers, and plenty of PPE stored in an outside storage area.

Toxins and knives were locked and inaccessible to clients in a separate room. Medications were inspected and accounted for at the time of inspection. The patio area was clean and accessible to the clients. The first aid kit was checked and fully stocked with a certified manual. LPA reviewed the facility disaster plan. The facility disaster plan was current and in compliance with Title 22 at the time of visit. Staff records and P&I were presently available for immediate review and inspection.

An exit interview was conducted, with the DSP Akechi Onuoha and a copy of this report was provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024
LIC809 (FAS) - (06/04)
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