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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603296
Report Date: 05/07/2024
Date Signed: 06/13/2024 01:07:58 PM

Document Has Been Signed on 06/13/2024 01:07 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:HOUSE OF HOPE ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
198603296
ADMINISTRATOR/
DIRECTOR:		MARTIN, CHERRYFACILITY TYPE:
735
ADDRESS:1000 NORTH ROSE AVENUETELEPHONE:
(714) 553-2048
CITY:COMPTONSTATE: CAZIP CODE:
90221
CAPACITY: 4CENSUS: DATE:
05/07/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Administrator Morigan CoffeeTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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On 05/07/24 LPA Villegas conducted a case management visit to verify facility is able to accommodate 4 clients as an increase from 3 to 4 clients was requested. LPA met with Administrator Morigan Coffee as the purpose of today's visit was explained. LPA and Administrator toured the facility in order for LPA to verified that bedroom# 1 is a double room and is large enough to accommodate 2 clients in care, bedroom #2 and bedroom #3 are both single bedrooms with required furniture. During LPA's visit there were no health and safety concerns observed.

Exit interview was conducted with Administrator Morigan Coffee, and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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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