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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603528
Report Date: 06/18/2024
Date Signed: 06/18/2024 09:45:25 AM

Document Has Been Signed on 06/18/2024 09:45 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:WARVALE FACILITYFACILITY NUMBER:
198603528
ADMINISTRATOR/
DIRECTOR:		HERNANDEZ, YESSICAFACILITY TYPE:
735
ADDRESS:8740 WARVALE ST.TELEPHONE:
(323) 346-3450
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 4CENSUS: 2DATE:
06/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:27 AM
MET WITH:Edgar Hernandez - AdministratorTIME VISIT/
INSPECTION COMPLETED:
10:16 AM
NARRATIVE
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Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced case management visit on the home. LPA was met by Edgar Hernandez, administrator for the facility, and was granted entrance. The visit was conducted in response to a semi-annual residential review conducted by the East Los Angeles Regional Center.

LPA conducted a health and safety check including measuring the hot water temperature in the facility, which measured between the required range of 105 - 120 degrees Fahrenheit. LPA also observed that the facility keeps all knives, sharp objects, chemicals, and cleaning supplies in locked areas of the facility. LPA observed the facility has a sufficient perishable and non-perishable food supply, and that the facility is sanity and in good repair. LPA also observed the facility has a disaster plan on file, and their last documented disaster drill was documented on 3/14/2024. LPA also reviewed the client files and observed that they were complete and met all required regulations. Upon further record review LPA determined that staff providing between 10 PM - 7 AM are trained on the facility's emergency and disaster drills.

Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were observed during the visit. Exit interview held and a copy of the report along was provided to the administrator.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2024
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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