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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602390
Report Date: 11/16/2022
Date Signed: 11/16/2022 01:22:55 PM

Document Has Been Signed on 11/16/2022 01:22 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:DANIELLA'S HOMEFACILITY NUMBER:
198602390
ADMINISTRATOR:COELLO, BESSIE LFACILITY TYPE:
740
ADDRESS:18005 OSAGE AVENUETELEPHONE:
(310) 371-4088
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY: 6CENSUS: DATE:
11/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Natalia Torres House ManagerTIME COMPLETED:
01:28 PM
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Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced Annual inspection visit and infection control inspection to the above facility. LPA was later met by Bessie L Coello Administrator the purpose of today’s visit was explained.

There are currently (4) Regional Center consumers in placement. All (4) clients are ambulatory. The facility is a two-story structure located in a residential neighborhood. It consists of the following: 4 bedrooms, 2 bathrooms, family room/office, living room, kitchen, dining room, shaded area, indoor and outdoor activity area, laundry room in no garage.

LPA and Administrator toured the entire facility inside and out. Documents are posted as mandated by the DPH and CCLD. Bedrooms 1 – 4 are occupied by clients, all contained the mandated furniture. The (2) bathrooms are clean and operational. Smoke detectors and carbon monoxide detector are in compliance and operational. No firearms are stored at facility, body of water present in the form of a pool which is screened. Medications are stored, locked and inaccessible to clients. 1 staff file is current, 1 resident file is current along with medications. The water temperature is at 180.1 degrees. A comfortable temperature is maintained in the facility. Ample supply of perishable and nonperishable food, linens and personal hygiene supplies are adequate, hazardous toxins and/or items are inaccessible to clients, 2 fire extinguishers are charged.

LPA received the following documents from the administrator, Client Roster, Employee Roster, Liability Insurance, Fire Prevention Ins, Stipulation and Waiver and Order unsigned, Copy of Floor Plan

LPA will continue inspection at a later date no citations issued at this time.

An exit interview conducted with Bessie L Coello, Administrator and copy of report provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Jeremiah Randle
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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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