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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603336
Report Date: 05/05/2023
Date Signed: 05/05/2023 11:36:34 AM

Document Has Been Signed on 05/05/2023 11:36 AM - 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:BAILEY'S PLACE ADULT COMMUNITY CENTER LLCFACILITY NUMBER:
198603336
ADMINISTRATOR:BROOKS, BRANDIFACILITY TYPE:
775
ADDRESS:1216-1218 E. ROSECRANS AVETELEPHONE:
(214) 240-4247
CITY:COMPTONSTATE: CAZIP CODE:
90221
CAPACITY: 32CENSUS: 19DATE:
05/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Yolanda Williams-DirectorTIME COMPLETED:
11:36 AM
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 On 5/5/2023 at 8:50 AM, LPA Alfonso Iniguez visited the facility unannounced. The purpose of today's visit was to conduct an unannounced annual inspection of the facility. On today's visit, LPA met with facility staff Yolanda Williams-Director. The facility profile shows that the facility is licensed for a capacity of (32) clients, of which (3) may be non-Ambulatory. The administrator stated that the facility has (19) clients enrolled in the program. The total number of non-ambulatory clients attending the program is (2). The staff-to-client ratio is (1) staff to (2) clients.

Director stated that the facility has (4) clients with a Restricted Health Care condition (Diabetes). Currently, there are (0) clients using protective devices. The facility conducted a fire drill on 4/10/2023, and a Disaster Plan was on file. The last inspection held by the fire department was on 11/21/2022. The program does not provide transportation.

As a part of today's inspection, LPA reviewed 5 client records, 5 staff records, and medications and inspected the entire facility inside and out. LPA and Director toured the entire facility. The facility is a single-story facility with 2 offices, 1 conference room, 2 restrooms, 1 activity area, 1 computer area, and a TV area. The facility has a 3-car parking lot. There are 5 picnic tables outside, with a large umbrella for shade and a locked shed for storage. The passageways, walkways, and driveways are free from obstructions. The facility has board games, books, and other recreational materials for the client's use.

Evaluation Report continues LIC 809-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: BAILEY'S PLACE ADULT COMMUNITY CENTER LLC
FACILITY NUMBER: 198603336
VISIT DATE: 05/05/2023
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The front, back, and side areas are free of hazards and obstructions. 2 restrooms have working toilets and wash basins. They will accommodate non-ambulatory clients in a wheelchair. Emergency Phone Numbers are Posted & readily available for review in the activity area. 2 Fire Extinguishers are in the activity area mounted on the wall; a 3rd extinguisher is located by the rear exit door. The facilities telephone system is working correctly.

Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured in bathroom #1 was 109.5° F. In the bathroom, #2 was 110.5° F. A comfortable temperature is maintained in the facility. A total of 4 smoke detectors are connected, battery operated & working. The Carbon Monoxide detector is operational. The refrigerator has a temperature of at least 45°F. for appropriate food storage. The freezer is at 0°F. The facility is equipped with central air and heat. Toxins were Locked/stored in an outdoor storage shed.

A first aid kit has been inspected, with at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and current first aid manual, which are stored in locked steel drawers, available for staff use but inaccessible to clients.
The facility does not handle the cash resources of clients. Records of staff and clients are stored in a locked cabinet.

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

An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to the Director/ Yolanda Williams
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023
LIC809 (FAS) - (06/04)
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