<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603508
Report Date: 05/26/2023
Date Signed: 05/26/2023 12:28:50 PM


Document Has Been Signed on 05/26/2023 12:28 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:REM CALIFORNIA, LLC - BELLFLOWERFACILITY NUMBER:
198603508
ADMINISTRATOR:MANALASTAS, ALBERTOFACILITY TYPE:
735
ADDRESS:6129 BELLFLOWER BLVDTELEPHONE:
(562) 866-9634
CITY:LAKEWOODSTATE: CAZIP CODE:
90713
CAPACITY:4CENSUS: 4DATE:
05/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Martel Plotnick - AdministratorTIME COMPLETED:
12:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Tena Herrera and Licensing Program Manager (LPM) David Sicairos made an unannounced case management visit to Rem California, LLC - Bellflower. The purpose of todays visit was to serve the ORDER TO INDIVIDUAL FOR IMMEDIATE EXCLUSION FROM FACILITY on Staff #1 (S1). An investigation by the California Department of Social Services was conducted and it was determined that S1 violated California Code of Regulations Title 22, for personal rights.

On today's visit LPA and LPM met with Administrator Martel Plotnick. Copies of the immediate exclusion letter was delivered in person to Administrator.
SUPERVISOR'S NAME: David SicairosTELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Tena HerreraTELEPHONE: 323-980-4633
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1