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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603092
Report Date: 03/06/2024
Date Signed: 03/06/2024 04:14:22 PM


Document Has Been Signed on 03/06/2024 04:14 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:TORRANCE REGENCY SENIOR LIVINGFACILITY NUMBER:
198603092
ADMINISTRATOR:LAMB, JONNA LFACILITY TYPE:
740
ADDRESS:22929 PETROLEUM AVETELEPHONE:
(424) 263-4823
CITY:TORRANCESTATE: CAZIP CODE:
90502
CAPACITY:6CENSUS: 6DATE:
03/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Administrator Jonna Lamb.TIME COMPLETED:
04:30 PM
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On 03/06/24 at 1:10PM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Administrator Jonna Lamb.

The facility is licensed to serve (6) non-ambulatory residents 60 and over of which (5) may be bedridden. Bedrooms approved for bedridden are rooms 2,3,4,5 and 6. Facility has an approved hospice waiver for (6) residents.

The facility is a single-story home located in a residential neighborhood and consists of (6) resident bedrooms, (1) staff bedroom, (1) resident bathroom, (1) private bathroom located in room #1, 1 staff bathroom, living room, dining area, staff working area, kitchen, laundry area, de- attached garage and a backyard with a shaded seating area.

Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed.

Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises.

Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature properly measured between 105.8F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked.

Common areas were clean and clear of hazards, doorways were free of obstructions.

Continue to LIC 809-C

SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina CloydTELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2024
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
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: TORRANCE REGENCY SENIOR LIVING
FACILITY NUMBER: 198603092
VISIT DATE: 03/06/2024
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LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxics were kept in locked storage cabinet. First Aid kit was available. Fire extinguisher, last serviced February 16, 2023 was observed. Staff tested carbon monoxide and smoke detectors located throughout the facility. Devices were functional and interconnected.

5 staff records were reviewed, 5 out of 5 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions. Two staff interviews were conducted.

5 resident records were reviewed and, 5 out of 5 resident records had medical assessments and pre-appraisals/reappraisals. Two residents’ medication was reviewed and two residents were interviewed.

No deficiencies are being cited.

An exit interview was conducted, technical assistance provided, and a copy of this report was discussed and left with the Administrator Jonna Lamb.

SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina CloydTELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
LIC809 (FAS) - (06/04)
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