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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602577
Report Date: 04/04/2022
Date Signed: 04/05/2022 06:41:28 AM

Document Has Been Signed on 04/05/2022 06:41 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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:CALIFORNIA EMPLOYMENT DEV & SUPPORT SERVICES INCFACILITY NUMBER:
198602577
ADMINISTRATOR:ENUNWA, JOHNFACILITY TYPE:
775
ADDRESS:14127-14127 1/2 CRENSHAW BLVDTELEPHONE:
(310) 617-5912
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 30CENSUS: 14DATE:
04/04/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:38 PM
MET WITH:ENUNWA, JOHNTIME COMPLETED:
03:39 PM
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On 4/4/2022, LPA Ngozi Nwaokoro conducted an unannounced annual/required one year inspection of the California Employment Dev & Support Services Inc, Adult Day Program, with emphasis on Infection Control. LPA Nwaokoro met with John Enunwa, Administrator and explained the purpose of the visit. The facility is located in a commercial mall. The California Employment Dev & Support Services Inc. (CAEDSS) Day program is licensed for 30 clients, on the day of this visit, the facility had 14 clients, operating hours are Wednesdays and Friday from 8:00am - 3:00pm for now, due to the pandemic. Clients are required to bring their own lunch; however, if a client does not bring a lunch, the facility will provide lunch for the client. The CAEDSS Day Program does not handle cash resources for the clients or dispenses medication. LPA and Administrator toured the facility, reviewed client records, staff records, and inspected the entire facility.

LPA observed the following during inspection of facility: 2 Parking lots(drop off/pick up areas), both facility entrances have wheelchair ramps for non-ambulatory clients, lobby area, with reception and client workstations, client storage room, lunch prep room with refrigerator, microwave, trash can, and also a small dinning table, in addition second lunch area with table and chairs, Activity room with Workstations, including 2 computer workstations, a resource center, 2 bathrooms (bathroom#1 is accessible for non-ambulatory clients includes grab bars), staff office, quiet room, and a director’s office.



All facility rooms are clean and in good repair. LPA observed bathrooms were found to be within Title 22 regulation. All bathroom fixtures are clean, in good repair and working properly. Documents are posted as mandated by Title 22 Regulations. Smoke detectors are in compliance. The Fire alarm system (hardwired), (2) carbon monoxide are operable and working, and three (3) fully charged fire extinguishers located in the facility: entrance, activity room, and resource center. All exit doors have push bars and emergency exit maps. All rooms have required furniture and equipment necessary to conduct all activities.
SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Ngozi Nwaokoro
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2022
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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: CALIFORNIA EMPLOYMENT DEV & SUPPORT SERVICES INC
FACILITY NUMBER: 198602577
VISIT DATE: 04/04/2022
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Hazardous items are inaccessible to clients and located in a locked cabinet. All trash cans have tight lids. First aid kit fully stocked with manual. Bathroom #1: hot water temperature is 114 F and bathroom #2 hot water temperature is 115.1 F.

No deficiencies were cited at this time.

An exit interview was conducted and a Facility Evaluation Report and was provided to John Enunwa.
SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Ngozi Nwaokoro
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2022
LIC809 (FAS) - (06/04)
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