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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320164
Report Date: 07/11/2024
Date Signed: 07/11/2024 03:39:23 PM

Document Has Been Signed on 07/11/2024 03:39 PM - 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:PAPA JOE'S HANDSFACILITY NUMBER:
198320164
ADMINISTRATOR/
DIRECTOR:		SWAFFORD, RASHIMERFACILITY TYPE:
740
ADDRESS:216 E. 137TH. ST.TELEPHONE:
(310) 562-7694
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY: 4CENSUS: 3DATE:
07/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Administrator - Rashimer SwaffordTIME VISIT/
INSPECTION COMPLETED:
03:50 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 07/11/2024 at around 2:00 PM, Licensing Program Analyst (LPA) Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Licensee/Administrator, Rashimer Swafford. LPA explained the purpose of the visit and was accompanied by a staff inside and outside the facility during this inspection.

This facility is licensed to serve 4 adults ages 55 and above.

A total of 3 ambulatory residents are currently residing in this facility.

The facility is a one-story house located in a residential street. The home consists of 4 resident bedrooms, 3 bathrooms, 1 living room, 1 dining room, 1 kitchen, 1 attached garage, 1 community room, and 1 backyard patio area with shaded seating.

Due to time constraints, LPA was unable to complete annual inspection.

No deficiencies were cited. An exit interview was conducted and a copy of this report was left with the Administrator.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE: DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2024
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