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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320571
Report Date: 04/30/2026
Date Signed: 04/30/2026 11:35:06 AM

Document Has Been Signed on 04/30/2026 11:35 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:HELPING HANDS WITH CAREFACILITY NUMBER:
198320571
ADMINISTRATOR/
DIRECTOR:		ANDERSON, WHITNEYFACILITY TYPE:
740
ADDRESS:1428 E 142ND STREETTELEPHONE:
(310) 463-1352
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY: 6CENSUS: 0DATE:
04/30/2026
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Whitney AndersonTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 04/30/2026, Licensing Program Analyst (LPA) Jose Anguiano conducted an announced visit to the facility for the purpose of a pre-licensing evaluation. The pre-licensing evaluation was conducted with applicant Whitney Anderson.

On 01/31/2025, an application was submitted to Community Care Licensing Division (CCLD) for Residential Care for the Elderly. The requested capacity is (6) Residents, ages 60 and over, with (5) non-ambulatory and (1) bedridden to be placed in room number 3 only. The facility is a one-story home consisting of four (3) bedrooms and two (1) bathrooms.

CCLD staff conducted a review of the Physical Plant, Bedrooms, Bathrooms, Supplies, Food Service, Medications, Records, Administration, Activities, Pre-Licensing Checklist, and Component III Orientation.

MEDICATIONS
There is a locked, centralized storage area for resident medications inside of a office area that is locked and inaccessible to residents.

PHYSICAL PLANT
The facility is clean, sanitary, and in good repair. Protective devices are in place, including non-slip material on rugs. Indoor and outdoor passageways, stairways, inclines, ramps, open porches, and other areas of potential hazard are free of obstructions. All window screens are clean and new and in good repair. The facility temperature is maintained between 69 degrees Fahrenheit. Stairways and areas of potential hazard are well-lit and equipped with sturdy handrails.

NAME OF LICENSING PROGRAM MANAGER: Ulysses Coronel
NAME OF LICENSING PROGRAM ANALYST: Jose Anguiano
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2026
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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: HELPING HANDS WITH CARE
FACILITY NUMBER: 198320571
VISIT DATE: 04/30/2026
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BEDROOMS
Halls, stairways, unfinished attics or basements, garages, storage areas, sheds, or similar detached buildings are not being used as resident bedrooms. Resident bedrooms are of adequate size to allow for easy passage and to accommodate furniture and assistive devices. No resident bedroom is a passageway to another room, bathroom, or toilet. Each resident has a bed with a mattress, mattress pad, bedsprings, and pillows, all of which are clean and in good repair. Mattresses and pillows are flame-retardant. Each resident has dresser and closet space. A chair and lamp are provided for each client, and at least one (1) night stand is provided per resident in care.

BATHROOMS
There are two (2) toilets and washbasins available for client, family, and personnel use. There is at least one (1) shower or bathtub per ten (10) residents, family, and personnel. The hot water temperature was measured at 117 degrees Fahrenheit. Bathrooms are located near client bedrooms.

SUPPLIES
Client personal hygiene supplies are available, including soap, toothpaste, toilet paper, and combs. There is a sufficient supply of clean linens to permit weekly changing, or more often as needed, including top sheets, bottom sheets, bedspreads, blankets, pillowcases, mattress covers, bath towels, hand towels, and washcloths.

FOOD SERVICE
The dining room is located near the kitchen. Refrigerators and freezers are clean and of sufficient size to store at least two (2) days of perishable food. The freezer temperature is maintained at 0 degrees Fahrenheit, and the refrigerator does not exceed 40 degrees Fahrenheit. A seven (7) day supply of non-perishable food is available. The kitchen, including all equipment, dishes, utensils, food storage, and preparation areas, is clean and in good repair.

RECORDS
Confidential storage of personnel records is maintained at the facility. Confidential storage of resident records is also maintained in the office area.

Please see (LIC809-C) for report continuation.

NAME OF LICENSING PROGRAM MANAGER: Ulysses Coronel
NAME OF LICENSING PROGRAM ANALYST: Jose Anguiano
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: HELPING HANDS WITH CARE
FACILITY NUMBER: 198320571
VISIT DATE: 04/30/2026
NARRATIVE
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ADMINISTRATION
The emergency exit plan and emergency phone numbers are posted. Resident Personal Rights are posted, which meets the requirement. The facility visiting policy and Licensing Complaint Poster are posted. Space is available for resident council meetings and postings.

ACTIVITIES
There is outdoor activity space available with two (2) shaded areas, furnished for outdoor use. There is at least one common room available for residents to receive visitors.

MISCELLANEOUS
First-aid supplies are available, including sterile dressings, bandages, adhesive tape, scissors, tweezers, a thermometer, antiseptic solution, and a current first-aid manual. There is space and equipment available for laundry. Separate areas are designated for clean linen storage and soiled linen. There is an operating telephone available to residents. Emergency lighting and supplies, including flashlights with batteries, are available.

COMPONENT III
Component III was provided in person. Information was reviewed with the applicant regarding operating the facility in substantial compliance. An exit interview was conducted, and a hard copy of this report was provided to the applicant.

Accordingly, the LPA will submit a copy of this facility evaluation report to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to contact the assigned CAU Analyst.

NAME OF LICENSING PROGRAM MANAGER: Ulysses Coronel
NAME OF LICENSING PROGRAM ANALYST: Jose Anguiano
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC809 (FAS) - (06/04)
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