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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320510
Report Date: 01/06/2026
Date Signed: 01/06/2026 12:03:14 PM

Document Has Been Signed on 01/06/2026 12:03 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:COMFY CARE HOME, INCFACILITY NUMBER:
198320510
ADMINISTRATOR/
DIRECTOR:		DRAPEAU, MAYFACILITY TYPE:
740
ADDRESS:22620 MADISON STTELEPHONE:
(310) 930-6455
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY: 6CENSUS: 5DATE:
01/06/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On 01/06/2026 at 8:15am, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Required 1-year Annual Visit to the facility listed above. LPA met with Administrator May Drapeau, 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 over the age of 60, three (3) of which may be bedridden, and an approved hospice waiver for two (2) residents.
Physical Plant/Structure The facility is a single-story structure in a residential neighborhood. The facility consists of four (4) bedrooms, two (2) full bathrooms and ½ bathroom, kitchen, dining room, living room, office/receiving area, attached garage, front and backyard. The backyard has a shaded patio with table and chairs. The front and backyard are well maintained. All walkways outside were observed clean, clear, and free of obstructions, debris, and hazards. Gates on the side of the home open easily from the inside to exit. There were no bodies of water observed on the premises.
Bedrooms LPA inspected all residents’ bedrooms and observed them to be clean and in good repair. LPA observed all bedrooms have the required furniture including a bed(s), dresser(s), nightstand(s) with lamp(s), chair(s), and ample storge space for resident 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 garage. Bedrooms were observed with ample lighting.
Bathrooms LPA inspected all bathrooms and observed them to be within Title 22 regulations. All bathrooms were observed to be clean and operable. All showers had secured safety handrails, nonskid mats, and shower chairs available. The water temperature measured 108.7-degrees, 109-degrees, and 112.8-degrees Fahrenheit. LPA observed hygiene products secured in a cabinet in the garage. LPA observed an ample supply of towels in a cabinet in the garage.
NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2026
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: COMFY CARE HOME, INC
FACILITY NUMBER: 198320510
VISIT DATE: 01/06/2026
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Kitchen LPA inspected the kitchen and found it to be clean and sanitary. LPA observed an ample supply of cookware, dishware, and cutlery in good repair. LPA observed a 3-day supply of perishable foods and a 7-day supply of nonperishable foods properly stored, labeled and dated. LPA observed all sharps and knives secured in a locked drawer and are inaccessible to residents. LPA observed all cleaning supplies secured in a locked cabinet under the kitchen sink and are inaccessible to residents. The water temperature measured 108.9-degrees Fahrenheit.
Common Areas LPA inspected all common areas. The dining room has a large table with chairs to accommodate all residents. The living room has two (2) couches and four (4) recliners to accommodate residents. LPA observed a fireplace that is screened, and inaccessible to residents. LPA observed games, puzzles, books, and reading material available for residents in the living room. LPA observed a desk and two (2) couches in the receiving area. All rooms were observed with ample lighting. All walkways and hallways were observed clean, clear, and free of obstructions and hazards. The facility was maintained at a comfortable temperature.
Medications LPA observed Centrally Stored Medications secured in a locked cabinet in the receiving/office area and are inaccessible to residents. LPA observed Centrally Stored Medications in their original packaging. LPA reviewed the medications for five (5) residents. LPA observed five (5) out of five (5) residents’ medications is consistent with properly documented records.
Files LPA observed staff and resident files secured in a locked cabinet in the receiving/office area that are inaccessible to residents and visitors. LPA reviewed five (5) resident files and observed they have the required documents. LPA reviewed the files for the administrator and three (3) staff and observed they have the required documents, certification, clearance, and training. The administrator’s Administrator Certificate 7004394740 is valid till 06/27/2026. LPA reviewed the facility’s liability insurance through Acord valid till 09/12/2026.
Safety LPA observed three (3) fully charged fire extinguishers. One extinguisher is mounted in the kitchen, one is mounted in the garage, and the third is mounted in the hallway near the bedrooms. The smoke detectors are hardwired and fully operational. LPA observed four (4) carbon monoxide detectors that are operational. All rooms have a facility sketch that shows emergency exits. LPA observed the last emergency drill was conducted on 12/01/2025. The last fire prevention inspection was conducted by the Torrance Fire Department on 08/14/2024. The Emergency and Disaster Plan was last reviewed on 12/01/2025. All doors exiting the facility have a sensor that alerts staff when a door is opened. LPA observed all exits are indicated with an EXIT sign. LPA inspected the First Aid Kit and found it contained all the required items and a current
NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
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: COMFY CARE HOME, INC
FACILITY NUMBER: 198320510
VISIT DATE: 01/06/2026
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manual. The facility has a working landline telephone. LPA observed all required state posting throughout the facility. There are no firearms or ammunition stored at the facility.
Infection Control During today’s visit, LPA observed the facility’s infection control practices. At the entrance there are sanitizing stations that has hand sanitizer, masks, and a visitor log. LPA observed Infection Control signs posted throughout the facility. LPA observed a 30-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 May Drapeau, 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: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
LIC809 (FAS) - (06/04)
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