Facility Evaluation Report

Ultimate Care III, El Segundo05/29/2026Licence 198200507

Capacity4
Census4
Date signed05/29/2026 12:00:19 PM
Name of licensing program analystGlenn Trueman
Name of licensing program managerWei Siew Ho
The inspector’s account

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit and was greeted by House Manager Deborah Lewis and explained the reason for the visit. The purpose of the visit is to complete the required inspection.

LPA Trueman toured the facility along with House Manager Deborah Lewis today 05/29/2026 and the following was observed:

Facility consists of the following: 4 bedrooms, 2 bathrooms, family room, living room, kitchen, dining room/office, indoor and outdoor activity area, and laundry room in the detached garage. The facility is licensed to operate for (4) developmentally disabled or Mentally Ill adults ages 18 through 59. Inspection was done using the Care Tools and included:

Infection Control, Physical Plant and Environment Safety, Operational Requirements, Staffing, Personnel Records- Training, Client Rights Information, Client rights- Incident Reports, Food Service, Health Related Services, Incidental Medical Services, and Disaster Preparedness. 4 client files and 4 staff files were reviewed.

All 4 clients were at Day Program at time of visit.

Medication was administered per physician's directions.

Signage for hand washing and proper sanitizing were posted. Staff have been trained in hand washing.

Staff responsible for providing care and supervision received training in First Aid.

Licensee maintained an individual admission agreement for each client.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction