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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320365
Report Date: 10/02/2025
Date Signed: 10/02/2025 05:00:59 PM

Document Has Been Signed on 10/02/2025 05:00 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:ALL CARESFACILITY NUMBER:
198320365
ADMINISTRATOR/
DIRECTOR:		GRINO, ZENAIDAFACILITY TYPE:
740
ADDRESS:3840 W. 181 STREETTELEPHONE:
(714) 747-4138
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 6CENSUS: 5DATE:
10/02/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:18 PM
MET WITH:Angelyn De LeonTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 10/02/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Annual Visit to the facility listed above using the full CAREs Tool. LPA met with Administrator Angelyn De Leon, and the purpose of today’s visit was explained. LPA was granted entry into the facility. The facility is licensed to serve six (6) non-ambulatory residents ages 60 and above, of which one (1) may be bedridden with an approved hospice waiver for six (6). The facility currently has five (5) residents, and one (1) is receiving hospice services.
Structure/Physical Plant The facility is a single-story structure in a residential neighborhood. The facility consists of four (4) bedrooms, two (2) bathrooms, kitchen, dining room, living room, attached garage, front and backyard. The backyard has a shaded patio with a table, chairs and activities. The front and backyard are landscaped and in good repair. All ramps have secured safety handrails. All walkways outside were observed clean, clear, and free of obstructions, debris, and hazards. There are no bodies of water on the premises.
Bedrooms LPA inspected all residents’ bedrooms. LPA observed all bedrooms have the required furniture including bed(s), dresser(s), nightstand(s) with a lamp, chair(s), and ample storage space for residents use. All beds had the required linens, including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed an ample supply of bed linens stored in a cabinet in the hallway and an additional supply in the residents’ closets. All bedrooms were observed to be in good repair.
Bathrooms LPA inspected all resident bathrooms. All bathrooms were found to be within Title 22 regulations. All bathrooms were observed to be operable. The showers were observed clean, and clear of mold or mildew. All showers have secured safety handrails, non-skid mats, and shower chairs available. The water temperature measured 115.6-degrees and 116.1-degrees Fahrenheit. LPA observed hygiene products secured in a cabinet under the sink and are inaccessible to residents. An additional supply was
NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: ALL CARES
FACILITY NUMBER: 198320365
VISIT DATE: 10/02/2025
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observed secured in a cabinet in the garage. LPA observed an ample supply of towels in a cabinet in the
hallway and an additional supply stored in each resident’s closet.
Kitchen LPA inspected the kitchen and found it to be clean and sanitary. LPA observed all appliances were operable and in good working repair. LPA observed an ample supply of dishware, cookware, and cutlery in good repair. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable foods properly packaged, labeled, and dated. All knives and sharps are secured in a locked drawer in the kitchen and are inaccessible to residents. The water temperature measured 114.7-degrees Fahrenheit. LPA observed the menu posted in the kitchen.
Common Rooms LPA inspected all common areas. The facility was observed appropriately furnished during time of visit. The dining room has a large table with chairs to accommodate all residents. The living room has a couch and chairs to accommodate residents. LPA observed a fireplace that is screened, locked, and inaccessible to residents. LPA observed games, puzzles, activities, books, and magazines available for residents. All rooms were observed to have ample lighting. All walkways inside the facility were observed clean, clear, and free of obstructions and hazards. The facility was maintained at a comfortable temperature.
Medications LPA observed all Centrally Stored Medications secured in a locked cabinet in the dining room and are inaccessible to residents. All Centrally Stored Medication were observed in their original packaging. LPA reviewed the Medication Administration Record (MAR) and medications for three (3) residents. LPA observed three (3) out of three (3) resident’s medications are consistent with properly documented records.
Safety LPA observed two (2) fully charged fire extinguishers lasted serviced on 03/06/25. One extinguisher was mounted in the kitchen, and the other was mounted in the garage. The smoke/carbon monoxide detectors are hardwired and fully operational. The last Fire Prevention Inspection was conducted by the Torrance Fire Department on 04/10/2025. The last Emergency Drill was conducted on 07/28/2025. All rooms have an emergency exit sketch posted with the exit route marked. LPA reviewed the facility’s liability insurance through Acord that is valid till 09/18/2026. LPA inspected the First Aid Kit and found it contained all the required items and manual. The door leading to the hallway where the bedrooms are located and the door to room 2 (bedridden room), are fire doors wired to the smoke detector system and if they are set off the doors close automatically. The facility has an alarm system that informs staff when a door is opened and identifies which door was opened. The facility has a working landline telephone. LPA observed all required state posting throughout the facility.
Files LPA reviewed the files for five (5) residents and observed they have the required documents. LPA reviewed the files for the Administrator and three (3) staff and observed they contained the required d
NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
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: ALL CARES
FACILITY NUMBER: 198320365
VISIT DATE: 10/02/2025
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ocuments, clearance, certification, and training. The administrator’s Administrator Certificate, number
7014407740, is valid till 03/20/2026. LPA observed Licensing Fees are current.
Infection Control During today’s visit, LPA observed the facilities infection control practices. At the entrance and throughout the facility, there are sanitizing stations. LPA observed all staff wearing face masks. LPA reviewed the visitor sign-in logs where temperatures are recorded. LPA observed Infection Control signs posted throughout the facility. LPA observed a 30-day supply of PPEs stored in the garage.

LPA did not observe or cite any deficiencies.

An exit interview was conducted with Administrator, Angelyn De Leon, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
LIC809 (FAS) - (06/04)
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