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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603188
Report Date: 09/19/2024
Date Signed: 09/19/2024 12:03:54 PM

Document Has Been Signed on 09/19/2024 12:03 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:BRUCE & NELSON RESIDENTIAL FACILITYFACILITY NUMBER:
198603188
ADMINISTRATOR/
DIRECTOR:		NELSON, KENDRA DFACILITY TYPE:
735
ADDRESS:1722 WEST 165TH STREETTELEPHONE:
(424) 785-5412
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 4CENSUS: 2DATE:
09/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:08 AM
MET WITH:Kendra NelsonTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 9/19/24, at 10:00am, Licensing Program Analyst (LPA) Perry Scott made an unannounced inspection to Bruce & Nelson Residential Facility. The purpose of today’s visit was to conduct the required annual inspection, using the new Care Tool. LPA was met by Kendra Nelson, Administrator, and the purpose of the visit was explained. The facility is licensed to serve four (4) developmentally disabled clients (age 18-59) of which four (4) may be ambulatory. Currently, the home has (2) ambulatory clients. The clients are South-Central Los Angeles Regional Center clients. None of the clients have Restricted Health Care Conditions and none utilizes postural supports or protective devices. The facilities’ annual fees are due on 10/22/24 for $454.00.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 3 bathrooms, family room/dining room, kitchen, living room, indoor and outdoor activity area, laundry room and an attached garage.

LPA conducted a records review of (2) client records, (4) staff records, and reviewed the facility disaster plan. All client & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (2) Client Medication Administration Records and did not observe any discrepancies at the time of visit.

At 10:30am, LPA and administrator toured the physical plant. All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, and adequate storage for client personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations. Toilets and water faucets worked properly. The water temperature was within Title 22 regulations and measured 106.6F degrees. A comfortable temperature is maintained in the facility.

Report continued on LIC809-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BRUCE & NELSON RESIDENTIAL FACILITY
FACILITY NUMBER: 198603188
VISIT DATE: 09/19/2024
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LPA observed the facility to be clean, storage areas for cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is enough perishable and non-perishable food available. Medications were centrally stored and properly locked, fire extinguisher was charged, and smoke/ carbon monoxide detectors were operable. The last fire/emergency drill was conducted on 09/09/2024.

During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA further observed the facility to have a 60-day supply of Personal Protective Equipment (PPE).

LPA advised the administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time.

An exit Interview was conducted, and a copy of the report was given to Kendra Nelson, Administrator.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC809 (FAS) - (06/04)
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