Facility Evaluation Report

Serenity One LLC, Harbor City10/08/2025Licence 198320198

Capacity4
Census4
Date signed10/13/2025 08:33:29 AM
Name of licensing program analystJose Calderon
Name of licensing program managerUlysses Coronel
The inspector’s account

On 10/08/2025 at 01:00 PM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Serenity One LLC Facility. LPA Calderon was allowed entry into the facility by Administrator Jimmy David. The facility is licensed to operate for four (4) developmentally disabled clients of between the ages of 18 through 59 of which three (3) can be non-ambulatory clients. Currently, the facility has four (4) residents living at the facility.

LPA Calderon explained to Administrator Jimmy David the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Four (4) client service records, four (4) client medication records, three (3) staff records, and inspected the inside facility and outside grounds. The facility’s last fire drill was conducted on 09/04/2025 . The one-story residential home consists of four (4) client bedrooms, two (2) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored on the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage and kitchen area.

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