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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602557
Report Date: 09/02/2021
Date Signed: 09/30/2021 06:38:47 PM

Document Has Been Signed on 09/30/2021 06:38 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:ALONDRA GUEST HOMEFACILITY NUMBER:
198602557
ADMINISTRATOR:VILLAFLORES, LOURDESFACILITY TYPE:
740
ADDRESS:11849 ALONDRA BLVDTELEPHONE:
(562) 863-7630
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 6CENSUS: 5DATE:
09/02/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Joylourdes VillafloresTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced Required 1 year inspection at the facility and met with Administrator JoyLourdes Villaflores and explained the purpose for todays visit. Prior to the visit LPA Wesley conducted a risk assessment for on-site inspections. The facility phone number is 562 863 7630.

The facility consist of six bedrooms(#1, #4 and #6 are for staff), three bathrooms,(one in bedroom #2, and #5), living room, dining room, kitchen and enclosed outdoor patio located in the back yard with washer and dryer, attached garage(storage and overflow of food).

LPA conducted a complete tour of the facility, and observe the supply of food. Resident medications, and medication are locked in staff room #6. The smoke detectors/carbon monoxide detector are operable. The Fire alarm system has a pull switch, and there is one fire extinguisher located by the kitchen/dining room area. The mitigation plan was approved on 04/09/2021.

Administrators certificate for Joy L Villaflores #6036177740 expired on 08/02/2021. The Administrator advised they are waiting on the new certificate to arrive, LPA Wesley observed canceled check dated 05/03/21.

Due to time constraints, LPA will return on a later date to complete the inspection. There were no deficiencies cited today.

Exit interview conducted
SUPERVISORS NAME: Rebecca Orendain
LICENSING EVALUATOR NAME: Nicol Wesley
LICENSING EVALUATOR SIGNATURE: DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/02/2021
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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