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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602548
Report Date: 12/08/2023
Date Signed: 12/08/2023 11:45:48 AM

Document Has Been Signed on 12/08/2023 11:45 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CHOICES R US - HONDOFACILITY NUMBER:
198602548
ADMINISTRATOR:LASHON JOHNSONFACILITY TYPE:
735
ADDRESS:7716 HONDO STTELEPHONE:
(562) 291-1549
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY: 4CENSUS: 4DATE:
12/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Gilber Cardenas TIME COMPLETED:
11:55 AM
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Licensing Program Analyst (LPA) Ashley Calderon conducted the unannounced Annual Inspection and met with DSP Vena Myles and DSP Quindelyn Brown who allowed the entry of the facility. Shortly after, LPA met with Supervisor Gilbert Cardenas and explained the reason of today's visit.

For today's inspection LPA used the Compliance And Regulatory Enforcement (CARE) Tools to inspect the facility. The facility is licensed for age range 18 through 59 and 4 ambulatory of which 2 may be non-ambulatory. The facility has (4) bedrooms and (2) bathrooms, backyard and an detached garage.

The following was observed, reviewed and inspected:

LPA reviewed all (4) clients files and reviewed Administrator's and (3) DSP staff files. Staff were cleared, CPR/First Aid certified and had all documentation's in place. Residents had appropriate documentation's, P&I Ledgers and Physician Report w/ TB.

LPA reviewed (4) client medications and Medication Administration Record, all medications had labels, in place and no deficiencies were observed.

LPA and Supervisor toured/inspected the physical plant: all bedrooms are designated for clients as private bedrooms, no staff bedroom, all bedrooms contain the required about of furniture and lighting fixtures, mattresses and box springs are in good repair, beds have the required amount of linen. (2) bathrooms were clean and operational. Hallway is free of obstructions, common areas are organized and appropriately furnished, telephone and internet in place for residents use. (Continuation 809-C...)

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2023
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: CHOICES R US - HONDO
FACILITY NUMBER: 198602548
VISIT DATE: 12/08/2023
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Hot water tested within Title 22 Regulations, of 105-120 F.

Locked areas for resident and staff files in place, medications, toxins and sharp objects inaccessible to residents in care.

Kitchen had supply of perishable and nonperishable foods, refrigerator, freezer, microwave and counter tops are clean, ample supply of dishes, cups, glasses and utensils.

Fully stocked first aid kit with current manual and tweezers.

Walls, floors and ceiling are in good repair, a comfortable temp was maintained throughout the entire facility.

Front and backyards are well maintained and free of debris, patio area with chairs, no bodies of water observed, trash cans with tight fitted lids.

Fire Drills are conducted Fire Drill: 10/01/23

Administrator Certificate Expires: 5/4/24

No Deficiencies cited under California Code of Regulations Title 22 .



Exit Interview conducted and a copy of this report was provided.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
LIC809 (FAS) - (06/04)
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