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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602630
Report Date: 03/13/2025
Date Signed: 03/13/2025 03:07:07 PM

Document Has Been Signed on 03/13/2025 03:07 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/
DIRECTOR:
ANDRADE, KARINAFACILITY TYPE:
775
ADDRESS:4008 FLORENCE AVETELEPHONE:
(323) 223-3079
CITY:BELLSTATE: CAZIP CODE:
90201
CAPACITY: 120CENSUS: 34DATE:
03/13/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Karina AndradeTIME VISIT/
INSPECTION COMPLETED:
03:15 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 03/13/2025 at 1:15 PM 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.
Annual Inspection includes the following Domains:
Infection Control, Physical Plant and Environmental Safety, Operational Requirements, Staffing, Personnel Records- Training, Client Rights Information, Client rights- Incident Reports, Food Service, Health Related services, Incidental Medical Services, Disaster Preparedness, and Emergency Intervention.
Ratio is 1 staff for every 4 clients. The census is 34 with 9 staff on shift.
Interviews were conducted with 4 clients and 4 staff. 4 client files and 4 staff files were reviewed
All staff were cleared and associated.
Signage for hand washing and proper sanitizing were posted. Staff have been trained in hand washing.
Direct care staff had a minimum of 8 hours of annual training,
Licensee maintained an individual admission agreement for each client.
Fire Clearance has been maintained.
There is an adequate number of direct care staff to support each resident's physical, social, emotional safety and health care needs as identified in his/her current appraisal.
Each client has personal rights free from corporal or unusual punishment, infliction of pain, humiliation, ridicule, coercion, threats, mental abuse, or other actions of a punitive nature.
Program site was clean, safe, sanitary, and in good repair at all times for the safety and well being of clients, employees and visitors.
No deficiencies. Exit interview conducted.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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