Facility Evaluation Report
On 05/06/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA met with Caregiver, and explained the purpose of the visit. LPA asked Caregiver call the Licensee to inform them that CCL was present. LPA learned that the Licensee and the Facility Designated Administrator were unable to come to the facility at this time. Shortly after, LPA met with Facility Designated Representative (FDR), Venice Andrews and explained the purpose of the visit.
Current census was 4. A brief interview with FDR Andrews was conducted. LPA reviewed 4 resident files and 3 staff files all of which were complete and up to date.
A tour of the facility was conducted. The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been purchased with a receipt attached to it with a date of 05/06/2025, smoke detector and carbon monoxide in working condition.
The kitchen area was toured. The kitchen area was toured. LPAs observed a non-perishable and perishable foods in the cabinets and refrigerator. Additional perishable food supplies were identified in the garage.
LPA observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPA observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components.
A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction