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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003781
Report Date: 09/09/2024
Date Signed: 09/19/2024 09:44:28 AM

Document Has Been Signed on 09/19/2024 09:44 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:AMBITIONS - SUNFIELD AVENUEFACILITY NUMBER:
306003781
ADMINISTRATOR/
DIRECTOR:		DAVENPORT, RENEEFACILITY TYPE:
735
ADDRESS:4734 SUNFIELD AVETELEPHONE:
(562) 982-4218
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY: 4CENSUS: 4DATE:
09/09/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:19 PM
MET WITH:Aliyah DawsonTIME VISIT/
INSPECTION COMPLETED:
02:53 PM
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On 09/09/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced Case Management visit at this facility. LPA was greeted by DSP Aliyah Dawson who explained the purpose of the visit to conduct a health and safety check. Dawson contacted Program Director China Hampton by telephone who later joined the inspection. LPA explained the inspection visit is in association with an incident on 02/17/24 and a case management visit on 02/22/24.

On 02/18/24, Renee Davenport former Program Director reported an incident concerning client #1 (C1) and staff #1 (S1) involving physical assault. The Department interviewed administrator #1 (A1) Renee Davenport regarding the incident involving (C1) and (S1). Interviews were conducted with clients #1-#4 (C1-C4). There was no interview available for staff #1 (S1) as the staff was suspended while an investigation was pending.

During today's inspection visit, LPA Dabuet audited service records for clients #1-#4 (C1-C4). LPA observed clients #1-#3 were out in the community. LPA observed client #4 (C4) performing art activity.

LPA Dabuet spoke with current Program Director China Hampton who indicated that staff #1 (S1) is no longer an employee of Ambitions-Sunfield Avenue nor is employed at any other Ambitions facilities. The termination of (S1) was based on an internal investigation conducted by the facility and Harbor Regional Center Kent Yamashiro. Hampton verified that (S1) was officially separated from CDSS Guardian effective 03/01/24. Hampton provided a recent copy of LIC 500 Personnel Report (dated: 08/01/24) to verify (S1) is not included on the work schedule.

An exit interview conducted with China Hampton and a copy of the report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2024
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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