Senior Care Records.

Facility Evaluation Report

16TH Street Home Care INC, Lancaster07/23/2025Licence 197609293

Capacity4
Census4
Date signed07/23/2025 02:09:41 PM
Name of licensing program analystAngelica Segovia
Name of licensing program managerTroy Agard
The inspector’s account

On 7/23/2025 at approximately 10:00 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the Co-Administrator Aniana Calderon and stated the reason for their visit.

LPA asked for the census and Staff/Client Roster. LPA conducted a physical plant tour at approximately 12:00 PM and the following was noted:

The facility is a single unit building with six (6) bedrooms and two (2) bathrooms currently occupying four (4) clients. There are two (2) designated staff rooms. The facility has an approved fire clearance for four (4) ambulatory clients. The facility is vendor through North Los Angeles Regional Center (NLARC) and is being operated at a Level II Adult Residential Home.

Common areas: The living rooms and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 75°F. LPA observed a fire extinguisher to be located in the kitchen and dated 10/03/2024. LPA observed required postings such as See/Say Something, Facility License, and Personal Rights located throughout the common areas. A working telephone was observed.

Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Kitchen appliances were observed to be working and in proper condition. The knives/sharps were observed to be kept within a locked box inside of a locked storage closet located near the entrance. Laundry Room: The laundry appliances were observed to be located near the kitchen. The laundry appliances were observed to be working and in proper condition. (continued on LIC 809-C)

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