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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602192
Report Date: 12/19/2024
Date Signed: 12/19/2024 01:38:49 PM

Document Has Been Signed on 12/19/2024 01:38 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:SAKURA GARDENS AT LOS ANGELESFACILITY NUMBER:
198602192
ADMINISTRATOR/
DIRECTOR:		JINA MALEKSARKISSIANSFACILITY TYPE:
740
ADDRESS:325 S BOYLE AVETELEPHONE:
(323) 263-9651
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 183CENSUS: 141DATE:
12/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:52 AM
MET WITH:Tomoko Hino - Sales DirectorTIME VISIT/
INSPECTION COMPLETED:
01:54 PM
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Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced case management visit in order to tour the physical plant of the facility. LPA met with Tomoko Hino, Sales Director for the facility, and explained the purpose of the visit.

During today's visit, LPA interviewed Staff #1 and 2 (S1 and S2), and toured the main building of the campus, the activity hall, the memory care unit, the dining hall and kitchen, along with the perimeter of the building. During the tour LPA observed that the former Intermediate Care Facility (ICF) building, which still remains on the facility campus, has been painted over in white in recent months to cover graffiti that was on the building. Additionally, the back entrances of the ICF building which border the Santa Ana 101 freeway have been welded shut as well to prevent trespassers from entering the building. During a tour of the facility the main building of the facility along with the activity room, memory care unit, dining hall, and the campus grounds were all observed to be clean and in good repair. LPA also observed that additional reinforced fencing has been installed along the Santa Ana 101 freeway as well in recent months, and has barbed wire encircling the top of the new fence. Pictures were taken of several areas of the campus grounds including the new perimeter fencing for the facility.

No deficiencies observed during today's visit. Exit interview help and a copy of the report was provided to the facility.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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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