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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603485
Report Date: 08/25/2023
Date Signed: 08/28/2023 07:50:33 AM


Document Has Been Signed on 08/28/2023 07:50 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:WHITTIER COTTAGE IIFACILITY NUMBER:
198603485
ADMINISTRATOR:TRAZO-BOHANAN, VILMAFACILITY TYPE:
740
ADDRESS:16222 MARLINTON DR.TELEPHONE:
(562) 315-9897
CITY:WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY:6CENSUS: 2DATE:
08/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Vilma Bohanan and James TrazoTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Angelica Rea conducted an unannounced visit for the purpose of conducting the required annual inspection. On today's visit LPA met with Administrator, Vilma Bohanan explained the reason for the visit.

The facility currently has 2 clients in care. The facility is a single-story building in a residential area, with a kitchen, dining room, living rooms, 3 client bedrooms, 2 bathrooms, backyard with shaded area and attached garage. Fire extinguisher observed in kitchen fully charged. There are smoke detectors/ Carbon monoxide located throughout the facility, tested and operational.

LPA, toured the facility inside and out, reviewed food supply, reviewed staff and client files, and reviewed resident medications. Bedrooms have the required furniture including bedframes, dressers, lamps, and chairs. Beds have the required linen and the linen is in good condition. Passageways and exits are free of obstruction. LPA toured the kitchen and observed 7 days of perishables and 2 days nonperishable. The front and backyard are well maintained. The resident bathrooms are clean, and showers have non-skid materials. The hot water temperature measured at between 105 and 120 degrees F. There is sufficient lighting throughout the facility. Infection control signs were observed throughout the facility. Medications reviewed for all clients and appears to be given as prescribed. Last emergency disaster drill was conducted on 7/30/23.

No deficiencies cited during today's visit. Exit interview conducted, copy of report provided to Mr. Trazo.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica ReaTELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2023
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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