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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602943
Report Date: 10/10/2023
Date Signed: 10/10/2023 12:59:52 PM


Document Has Been Signed on 10/10/2023 12:59 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
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754



FACILITY NAME:SLEEP EASYFACILITY NUMBER:
198602943
ADMINISTRATOR:KYRA SANCHEZFACILITY TYPE:
735
ADDRESS:1909 W 81ST STREETTELEPHONE:
(323) 286-9318
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:6CENSUS: 4DATE:
10/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Kyra SanchezTIME COMPLETED:
01:15 PM
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On 10/10/23, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced annual required visit. Upon arrival at the facility, LPA spoke with the administrator Kyra Sanchez over the phone. LPA Richard informed Administrator the purpose of today's visit. At 10:25 AM, Administrator Sanchez arrived at the facility and the visit was conducted. LPA and Administrator toured the physical plan.

The facility is a single-story family home located in a residential neighborhood. LPA Richard and Sanchez made a complete tour of the facility which included: Living room, dining room, kitchen, breakfast area, 4 bedrooms, 2 bathrooms, laundry room, storage room, detached garage, patio/shaded area, and indoor/outdoor activity areas. There were no obstruction on the premises or small bodies of water. Beds and bedding supplies were in good conditions, adequate lighting provided, storage for client personal belongings was observed. Bed linens, comforters, and bath towers were adequately stocked at the time of visit. The hot water temperature tested 111.7F degrees. Bathrooms were found to be within Title 22 regulations and were clean and operational.

LPA Richard verified that the administrator is present at the property 20+ hours per week. The facility annual fees are current. The facility currently has four (3) ambulatory South Central Los Angeles Regional Center (SCLARC) consumers in placement and (1) ambulatory West Side Regional Center.(WSRC).

Continued on LIC 809C
SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Antonine RichardTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2023
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 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SLEEP EASY
FACILITY NUMBER: 198602943
VISIT DATE: 10/10/2023
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 LPA observed that medications cabinet where they would be kept safe, locked and inaccessible. Documents are posted as mandated. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. 2 fire extinguishers where observed one in dining area and another in hallway leading to bedrooms, both fire extinguishers where fully charged.

LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted and available.

No deficiencies were cited during this inspection visit.

An exit interview held a copy of this report was provided to the Administrator Kyra Sanchez.
SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Antonine RichardTELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023
LIC809 (FAS) - (06/04)
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