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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004426
Report Date: 01/11/2024
Date Signed: 01/11/2024 02:01:48 PM

Document Has Been Signed on 01/11/2024 02:01 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:PRUDENT COMFORT HOMESFACILITY NUMBER:
306004426
ADMINISTRATOR:DORIS BELLFACILITY TYPE:
735
ADDRESS:1071-1073 E. 71ST STREETTELEPHONE:
(562) 470-7018
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 6CENSUS: 3DATE:
01/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:34 PM
MET WITH:Wykelia BradyTIME COMPLETED:
02:35 PM
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On 01/11/24, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Direct support staff Wykelia Brady as the purpose of the visit was explained. The facility is licensed to serve six (6) ambulatory brain injured/mentally disabled adults with restricted health conditions ages 18-59. The current census for the clients is three (3), only 1 client is linked to the Harbor Regional Center. Direct support staff was provided with annual fee’s information.

The facility is a 2 single-story buildings, on the same lot, The first building (1071) consists of 3 client bedrooms, 2 bathrooms, living room, dining room, kitchen, and attached garage that is used as a staff office/ storage. The second building (1073) consists of 2 Client bedrooms, 1 Live-in Staff bedroom, 2 bathrooms, living room, dining room, kitchen, and attached garage used as storage unit. Client bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to clients. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to clients, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards.

LPA conducted a records review of 2 staff records, 1 client records, 1 medication administration records, and 1 P&I ledger, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 12/20/23, 1 fire extinguisher fully charged and located in the kitchen in both units, carbon monoxide and smoke detectors are operational in both units, landline was observed.

Technical advisories were issued for: Personnel Records 82066(a)(6)

Exit interview conducted with Wykelia Brady, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2024
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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