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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320506
Report Date: 02/10/2025
Date Signed: 02/10/2025 04:20:28 PM

Document Has Been Signed on 02/10/2025 04:20 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:A GUARDIAN ANGEL GUEST HOMEFACILITY NUMBER:
198320506
ADMINISTRATOR/
DIRECTOR:		DANTING, SHIRLEY LFACILITY TYPE:
740
ADDRESS:1854 EL REY ROADTELEPHONE:
(424) 364-0289
CITY:SAN PEDROSTATE: CAZIP CODE:
90732
CAPACITY: 6CENSUS: 4DATE:
02/10/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Shirley Danting TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 02/10/2025, Licensing Program Analyst’s (LPA’s) Yolanda Rosser, LPA Rosser met with and toured the facility with Licensee, Shirley Danting and Ethel Monterroso, administrators. The facility plans to support individuals who are 60 years of age and older . The facility has a fire clearance for (5) non ambulatory, (1) bedridden. LPA assured fire extinguishers were charged and operable on the Announced Pre-Licensing visit.
Census is 4.

The facility is under new ownership.

The facility is a single-story with four(4) bedrooms, (1) Staff room and (3) three restrooms. LPA Rosser observed the following during a tour of the facility: living room/ activity room, dining room, and kitchen. The areas inspected have the required furnishings, lighting, and storage. The required perishable and non-perishable food supply was observed. LPA Rosser toured the detached garage and observed a washer/dryer. The patio area is located in the backyard and is shaded. The front yard landscape is clean and gated. The walkways around the facility are free of obstructions. The facility is newly renovated.

LPA Rosser conducted a test of the smoke and carbon monoxide detectors and found them to be functioning properly. LPA Rosser conducted a test of the water temperature in the bathrooms and kitchen. The water temperature registered at 106-115°F. LPA Rosser observed inaccessible storage areas for medications, sharp objects, and chemicals. All fire extinguishers were charged and operable. The facility is very well kept.


During this visit LPA Rosser found no corrections are needed. The Component III was completed during this visit.
An exit interview was conducted, and a copy of this report was provided to Administrator Shirley Danting.h.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Yolanda Rosser
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2025
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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