198603156-9-24-2024-11-AS-EGOZ-D9ET9Q-20240924143219

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198603156
Report Date: 09/24/2024
Date Signed: 09/24/2024 02:32:24 PM

Document Has Been Signed on 09/24/2024 02:32 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME:	WRIGHT PLACE III		FACILITY NUMBER:	198603156
ADMINISTRATOR:	BROWN, KEISHA		FACILITY TYPE:	740
ADDRESS:	3915 1/2 S HARVARD BLVD		TELEPHONE:	(323) 595-7917
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90062
CAPACITY:	4	CENSUS: 3	DATE:	09/24/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:24 AM
MET WITH:	Maalik Byers-Administrator		TIME COMPLETED:	02:45 PM

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On 09/24/24 Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced annual inspection visit to the above facility using the CARE tool. LPA met with Administrator, Maalik Byers, and the purpose of today’s visit was explained. The facility is licensed to operate for four (4) ambulatory only developmentally disabled adults ages 18 through 59. Currently, there are three (3) clients in placement.

The facility is a single-story home located in a residential neighborhood. It consists of three (3) bedrooms, one (1) bathroom, living room, dining area, kitchen, outside patio, and an outside patio area.

LPA Gonzalez and Maalik Byers toured the inside and out of the physical plant. There were no bodies of water or obstructions on the premises. Exits/ Walkways around the facility were free of debris and hazards. All client rooms were inspected. Bedrooms had the required furniture and in good condition, adequate lighting was observed, and sufficient closet/drawer space to accommodate the client comfortably. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were clean and operational and found to be within Title 22 regulations. The water temperature properly measured between 105.0 F and 120.0 F. A comfortable temperature was maintained in the facility.

LPA observed the facility to be sanitary and appropriately furnished at the time of visit. The kitchen was inspected and there is sufficient perishable and non-perishable food supply and maintained adequately. Sharps, toxins, cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. LPA reviewed the Client’s Medication Administration Records (MAR) and did not observe any discrepancies at the time of visit. A landline was observed. Smoke detectors and carbon monoxide were tested and are working properly. Fire extinguishers were fully charged. A stocked First Aid kit along with manual was available. The facilities’ last fire drill was conducted on 06/18/2024.

Continued on LIC809-C

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Elvira Gonzalez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2024

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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WRIGHT PLACE III	FACILITY NUMBER: 198603156
	VISIT DATE: 09/24/2024

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During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). There are sanitizing stations in common areas and restrooms. All mandated inspection control posters were posted.

During this inspection, LPA did not observe any deficiencies, therefore no citations were issued at this time.

An exit interview was conducted, and a co.py of the report was given to Administrator, Maalik Byers.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Elvira Gonzalez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2024

LIC809 (FAS) - (06/04)

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