Senior Care Records.

Facility Evaluation Report

4219 W. 162nd Street Home, Lawndale05/05/2025Licence 197607735

Capacity3
Census3
Date signed05/13/2025 08:26:50 AM
Name of licensing program analystFelisa Shirley
Name of licensing program managerStephanie Cifuentes
The inspector’s account

On 5/5/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced annual required visit with a primary focus on Infection Control measures. LPA was met by the Administrator, Melanie Estepa and explained the purpose of today’s visit. The facility has a census of 3.

The facility is a one-story structure located in a residential neighborhood. The facility consists of (3) resident bedrooms, (2) client bathroom, living room, office located in the living room, kitchen, dining area, patio, garage used for storage and separate door for laundry area. Facility maintains all required posting throughout the facility.

LPA Shirley and Melanie walked through the kitchen and all appliances were in good working order. Knives were locked and stored in a drawer located in the kitchen, the medications were locked in a drawer in each of the residents rooms, inaccessible to residents. All files were locked in a cabinet located in the dining room. LPA observed a 3-day supply of perishable and a 7-day supply of nonperishable foods. The water temperature measured 116.3 degrees Fahrenheit.

Bedrooms 1-3 are occupied by residents and contain the mandated furniture. The (2) bathrooms have grab bars and are clean and operational. First aid kit is fully stocked with manual. No firearms are stored at facility and no bodies of water present. The facility is in good repair.

LPA Shirley and Melanie walked through all common areas. In the living room, kitchen, dining room there is ample seating and space for all residents. All rooms and walkways were clean, and clear of obstructions and hazards. All areas have ample lighting. All rooms, hallway, and living room have working smoke detectors. There is a charged fire extinguisher in the kitchen. The backyard is clean and clear of obstructions and hazards and there are no bodies of water present. There were no deficiencies issued.

An exit interview was conducted, and a copy of this report was provided to the Administrator, Melanie Estepa.

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