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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603504
Report Date: 11/14/2024
Date Signed: 11/14/2024 05:19:22 PM

Document Has Been Signed on 11/14/2024 05:19 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:LA POSADAFACILITY NUMBER:
198603504
ADMINISTRATOR/
DIRECTOR:		DIANA BAUTISTAFACILITY TYPE:
740
ADDRESS:8120 PAINTER AVETELEPHONE:
(562) 945-2651
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY: 114CENSUS: 86DATE:
11/14/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:14 AM
MET WITH:Diana Bautista, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
04:55 PM
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Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year . The purpose of the visit was explained to Business Office Manager Andrea Lopez. Administrator Diana Bautista arrived later. There facility serves residents 60 years and older.

During today's visit the following was completed:

  • 11 out of 12 Care Tool Domains were completed.
  • One (1) domain "Resident Records/Incident Reports" is pending review.
  • Deficiencies were observed and will be cited during Annual Continuation visit.


Due to time constraints, LPA will conduct an Annual Continuation visit.

Exit interview was conducted with Administrator Diana Bautista. A copy of the report was provided.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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