<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600749
Report Date: 12/16/2024
Date Signed: 12/16/2024 11:34:22 AM

Document Has Been Signed on 12/16/2024 11:34 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:VILLA SORRENTOFACILITY NUMBER:
191600749
ADMINISTRATOR/
DIRECTOR:
CARLA CHANFACILITY TYPE:
740
ADDRESS:23450 MADISONTELEPHONE:
(310) 539-6826
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY: 145CENSUS: 113DATE:
12/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:07 AM
MET WITH:Carla ChanTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/16/24, the department conducted an unannounced Case Management visit to the above facility to deliver a Decision and Order for a staff exclusion. During today’s visit the department met with Administrator Carla Chan and the purpose of today’s visit was explained.
The department delivered a copy of the Decision and Order (CDSS # 7923107022/OAH #2023110905). The department has excluded Staff Jonathan Menlo, and respondent is prohibited from employment in any facility licensed by the department, from presence in any facility licensed by the department, and from contact with clients from any facility licensed by the department The Order became effective December 5, 2024. The Order was provided to Administrator Carla Chan. Former Staff Jonathan Menlo was not present at the facility during the visit. Administrator stated they understand the Decision and Order and will not have Staff Jonathan Menlo present at the facility.
During today's visit, the department conducted a tour of the facility. During the tour, LPA met with all staff on shift at the facility. The department confirmed, Staff Jonathan Menlo is not working at the facility. During file review, the department found that Staff Jonathan Menlo was disassociated from the facility on 01/04/24.
During today’s visit the department did not observe or cite any deficiencies.
An exit interview was conducted with Administrator, Carla Chan, and a copy of this report was provided.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1