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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603334
Report Date: 11/08/2023
Date Signed: 11/09/2023 01:02:20 PM

Document Has Been Signed on 11/09/2023 01:02 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:ROSEVIEW TERRACEFACILITY NUMBER:
198603334
ADMINISTRATOR:CHAVEZ, KARENFACILITY TYPE:
735
ADDRESS:15607 S VISALIA AVETELEPHONE:
(310) 327-5660
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 6CENSUS: 3DATE:
11/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:02 PM
MET WITH:House manager Sherese ButlerTIME COMPLETED:
02:50 PM
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On 11/08/23, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with House manager Sherese Butler as the purpose of the visit was explained.

The facility is licensed to serve 6 Non-Ambulatory developmentally disabled clients (age 18-59), current census is 3. Clients are linked with the South Central Regional Center. The facility is a single-story structure located in a residential neighborhood and consists of the following: 3 bedrooms, 2 bathrooms of which 1 is private, linen closet, family room/dining room, kitchen, a second living room, staff office, outdoor shaded area, and an attached garage that houses a washer and dryer, cleaning supplies and serves as a storage space. There are no bodies of water or firearm/ammunition on the premises.

All client rooms were checked. Beds and bedding were in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to clients. The water temperature properly measured between 105-120 F.. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Toxins and knifes were observed to be stored and inaccessible to clients. Exits and walkways are free of debris/hazards.



LPA conducted a records review of 2 staff records, 1 client records, and 1 medication administration record. No discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 10/15/23, 1 fire extinguisher fully charged, carbon monoxide and smoke detectors observed and are operational. No discrepancies were observed during today's visit.

Exit interview conducted with house manager Sherese Butler and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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