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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602630
Report Date: 03/22/2022
Date Signed: 03/22/2022 03:09:53 PM

Document Has Been Signed on 03/22/2022 03:09 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:EL ARCA INCFACILITY NUMBER:
198602630
ADMINISTRATOR:ANDRADE, KARINAFACILITY TYPE:
775
ADDRESS:4008 FLORENCE AVETELEPHONE:
(323) 223-3079
CITY:BELLSTATE: CAZIP CODE:
90201
CAPACITY: 120CENSUS: 5DATE:
03/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Karina AndradeTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit and was greeted by Administrator Karina Andrade and explained the reason for the visit.
The purpose of the visit is to complete the required inspection.
LPA Trueman toured the facility along with Administrator Karina Andrade today 3/22/2022 at 11:30 AM and the following was observed:
Facility contains : Activity room, computer room, 2 restrooms, and resting room. Food is served for lunch from an outdoor vendor. Medications are currently not being administered for the clients currently attending program.
Required Annual inspection included Infection Control Domain and check of the food supply, medications and criminal clearance check.
All staff were cleared and associated.
Visitation signage was posted along with signage for hand washing and proper sanitizing.
Temperature checks are conducted.
Staff have been trained in hand washing.
Staff are sufficient with no shortages and there is a plan to replace workers if ill.
There are rooms available if isolation is needed.
Bathrooms have proper signage for hand washing. There are multiple stations for hand sanitizing.
Social distancing is implemented. Meal times are sanitized after each meal.
Facility has sufficient supply of PPE. Facility has a specific plan to ensure proper cleaning and disinfection of environmental surfaces and laundry; commonly touched surfaces are cleaned and disinfected at least once every shift . Plan when to notify medical provider if symptoms develop or COVID-19 exposure or when to call 911 for severe respiratory distress. No deficiencies. Exit interview conducted.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2022
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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