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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320203
Report Date: 08/17/2021
Date Signed: 08/17/2021 11:26:26 AM

Document Has Been Signed on 08/17/2021 11:26 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
CCLD Regional Office, 744 P STREET, MS 9-14-8201
SACRAMENTO, CA 95814
FACILITY NAME:ADORABLE REDBEAM HOMEFACILITY NUMBER:
198320203
ADMINISTRATOR:LINAYAO, KADIGUIA O.FACILITY TYPE:
740
ADDRESS:22521 REDBEAM AVE.TELEPHONE:
(424) 777-8707
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY: 6CENSUS: DATE:
08/17/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:03 AM
MET WITH:Kadiguia Linayao-Administrator/Managing MemberTIME COMPLETED:
10:20 AM
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Facility Type: RCFE
Application Type: CHOW
Capacity: 6
Census: 4
COMP II Participant: Kadiguia Linayao, Administrator/Managing Member
Interview Method: Telephone interview

On 8/17/21, applicant/administrator participated in COMP II. Identification of the applicant/administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant/administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained.

During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas:
1. Facility operation: License type, client/resident populations, and program
2. Admission Policies
3. Staffing requirements & Training
4. Restrictive/Prohibited Health Conditions
5. General provisions
6. Emergency Preparedness
7. Complaints & Reporting
8. Pre-licensing readiness
SUPERVISORS NAME: Mirella Quaranta
LICENSING EVALUATOR NAME: Anna Barrios
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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