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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603230
Report Date: 11/16/2024
Date Signed: 11/16/2024 05:33:48 PM

Document Has Been Signed on 11/16/2024 05:33 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:GARDEN TERRACE SENIOR LIVINGFACILITY NUMBER:
198603230
ADMINISTRATOR/
DIRECTOR:		CHOW, BRUCEFACILITY TYPE:
740
ADDRESS:720 N 4TH AVETELEPHONE:
(858) 598-3663
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY: 6CENSUS: 0DATE:
11/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Administrator Bruce ChowTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced required annual inspection visit on 11/16/2024 and was greeted by Administrator Bruce Chow . LPA Ramirez explained the purpose of the visit. The facility is located on a residential street and is a single store dwelling.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

The facility has currently ZERO (0) residents. The facility is currently being occupied by the licensee as a single family home. LPA Ramirez toured the facility and observed three (3) bedrooms, two (2) bathrooms, kitchen, living room, dining room, laundry room and attached garage. Licensee did not conduct emergency drills due to the facility not having residents. Licensee understands liability insurance will be obtained prior residents and staff entering into the facility. Administrator Bruce Chow has a current Administrator's Certificate with an expiration date of 10/25/2025. Staff files were maintained at the facility.

No deficiencies were observed during this inspection. Exit interview was conducted. A copy of this report was provided via email.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2024
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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