<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602852
Report Date: 02/26/2024
Date Signed: 02/26/2024 11:17:17 AM

Document Has Been Signed on 02/26/2024 11:17 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:PEOPLE'S CARE ROSEMEADFACILITY NUMBER:
198602852
ADMINISTRATOR:KRISTINE PANAMENOFACILITY TYPE:
775
ADDRESS:1280 SAN GABRIEL BLVDTELEPHONE:
(626) 802-5889
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY: 60CENSUS: 30DATE:
02/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:22 AM
MET WITH:Kristine Panameno, Program Manager TIME COMPLETED:
11:15 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Kristine Panameno, Program Manager called LPA Lopez on February 20th 2024 to report a small fire near the outdoor outlet, there where no injuries or damage according to Program Manager. It has since been repaired. On the day of the incident, Program Manager contacted 911 and was directed to contacted the fire department and was told to evacuate building. Program Manager evacuated the building and sent the participants to the Montebello Shopping center until everything was sorted out by the fire department.Fire department made visit to facility and inspected the location of the incident and cleared the building.
LPA took tour of facility and location of incident and found not risk of safety hazards.

Incident number 34066489 LAFD Captain Pseiffer

No deficiencies cited.

Exit interview conducted and copy of report provided.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1