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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602202
Report Date: 09/26/2023
Date Signed: 09/26/2023 09:55:14 AM

Document Has Been Signed on 09/26/2023 09:55 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:MERIDIAN HOME CAREFACILITY NUMBER:
198602202
ADMINISTRATOR:SAN AGUSTIN, JENNIFER GFACILITY TYPE:
740
ADDRESS:20526 WOOD AVENUETELEPHONE:
(310) 533-7898
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY: 6CENSUS: DATE:
09/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Joseph Sol-LicenseeTIME COMPLETED:
09:55 AM
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On 9/26/2023 Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced Case Management visit. Upon arriving at the facility, LPA met with Joseph Sol/Licensee who assisted with the visit. LPA explained the purpose of today's visit is to check on the facility water damage and the proposed eviction of residents.

On 9/14/23 RO received a call temporary relocation of residents due to a water leak. Administrator stated half of the facility floors was affected by the water leak and it needs to be repaired. On 9/25/23 RO received an email from licensee requesting an approval for eviction for all residents. On 9/26/23 LPA visited the facility an inspected the alleged water damage, LPA and administrator tour the entire facility. LPA took pictures where the water damage occurred. Licensee gave to LPA the scope of work from restoration company. Licensee stated to LPA that his plan is to relocate not evict the residents. Licensee wants to fixed the water damage at the facility and once the restoration is done, he will bring back his residents. Licensee will send a new email to RO stating his plan of relocation only.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time.



An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Joseph Sol/Licensee.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2023
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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