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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320203
Report Date: 09/13/2024
Date Signed: 09/13/2024 11:57:10 AM

Document Has Been Signed on 09/13/2024 11:57 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:ADORABLE REDBEAM HOMEFACILITY NUMBER:
198320203
ADMINISTRATOR/
DIRECTOR:		LINAYAO, KADIGUIA O.FACILITY TYPE:
740
ADDRESS:22521 REDBEAM AVE.TELEPHONE:
(424) 777-8707
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY: 6CENSUS: 5DATE:
09/13/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:46 AM
MET WITH:Kadiguia LinayaoTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 09/13/24, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit using the full CAREs tool. LPA met with Administrator, Kadiguia Linayao, and explained the purpose of today's visit. The facility is licensed to serve six (6) non-ambulatory residents over the age of 60, of which one (1) maybe bedridden and an approved hospice waiver for six (6). The facility currently has five (5) residents, two (2) who are receiving Hospice Care.
Structure/Physical Plant The facility is a single-story home in a residential neighborhood. It consists of 4 resident bedrooms, 3 bathrooms, kitchen, dining room, living room, outside shaded patio and attached garage. LPA and Administrator toured the facility. The front and backyard are landscaped and well maintained. All walkways on the outside of the home were observed clean, clear, and free of obstructions, debris, and hazards. All gates exiting the backyard open easily. LPA did not observe any bodies of water on the premises.
Bedrooms LPA inspected all resident bedrooms. All floors and walls were observed clean and in good repair. All bedrooms were observed to have the required furniture including bed(s), nightstand(s), dresser(s), chair(s), and adequate storage space for personal belongings. All beds had the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: ADORABLE REDBEAM HOME
FACILITY NUMBER: 198320203
VISIT DATE: 09/13/2024
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LPA observed an ample supply of bed linens in good repair. All bedrooms were observed with ample lighting.
Bathrooms LPA inspected all bathrooms. Bathrooms were found to be within Title 22 regulations and were observed to be clean and operational. All bathrooms had nonskid matts and shower chair. The safety grab bars are secured to walls. LPA observed an ample supply of towels and hygiene products available for residents. The water temperature measured 106.3 -degrees, 107.9 -degrees, and 109.3 -degrees Fahrenheit. LPA observed an ample supply of incontinent care supplies stored in resident rooms and an additional supply stored in the garage.
Kitchen LPA inspected the kitchen and found it to be clean and sanitary. All appliances were observed to be in good working repair. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable properly labeled and stored. LPA observed an ample supply of cookware, dishware, and cutleries in good repair. All sharps are secured in a locked drawer and are inaccessible to residents. All cleaning supplies are secured in locked cabinet under the sink and are inaccessible to residents. The water temperature measured 109.6. -degrees Fahrenheit.
Common Rooms LPA inspected all common rooms. The living room has a sofa, love sofa, and recliners to accommodate all residents. Puzzles, games, and activities were observed in the living room and dining room. The dining room has a large rectangular table and chairs to accommodate all residents. LPA observed a fireplace that was screened and inaccessible to residents. All walkways and hallways were observed to be clean, clear, and free of obstructions and hazards.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: ADORABLE REDBEAM HOME
FACILITY NUMBER: 198320203
VISIT DATE: 09/13/2024
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All rooms and walkways were observed to have ample lighting. All rooms were maintained at a comfortable temperature. LPA observed the facility to be properly furnished during time of visit.
Medications LPA reviewed the medications and Medication Administration Record (MAR) for three (3) residents. Three (3) out of three (3) resident’s MARs and medication are consistent with properly documented records. All medications were observed in their original containers. Centrally stored medications were observed secured in a locked cabinet in the office area.
Safety LPA observed a fully charged fire extinguisher, mounted on the wall at the kitchen entrance, last serviced on 12/09/23. The last emergency drill was conducted on 08/20/24. Smoke detectors and carbon monoxide detectors are operable. The facility has a working landline telephone. LPA observed all required signs and documents posted behind the facility front door. LPA inspected the First Aid kit and found it had the required items.
File Review LPA reviewed three (3) resident files and found they contained the required documents. LPA reviewed the Administrator and three (3) staff files and found they contained the required training, certification, and documents. The Administrator’s certificate is valid till 02/02/25. LPA reviewed a copy of the facility’s Liability Insurance through ACORD valid till 05/01/25. LPA observed the facility’s Licensing Fees are current.
Infection Control During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed all required
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: ADORABLE REDBEAM HOME
FACILITY NUMBER: 198320203
VISIT DATE: 09/13/2024
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Infection Control postings throughout the facility. LPA observed a 60-day supply of PPEs stored in the garage.

During today’s visit, LPA did not observe or cite any deficiencies.

An exit interview was conducted with Administrator, Kadiguia Linayao, and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024
LIC809 (FAS) - (06/04)
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