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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881300
Report Date: 06/23/2022
Date Signed: 06/23/2022 10:44:26 AM

Document Has Been Signed on 06/23/2022 10:44 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:ALL ABOUT CARING HOME 1FACILITY NUMBER:
331881300
ADMINISTRATOR:CANTORIA, ROBERT C.FACILITY TYPE:
740
ADDRESS:2606 CORONA AVE.TELEPHONE:
(310) 500-7223
CITY:NORCOSTATE: CAZIP CODE:
92860
CAPACITY: 6CENSUS: 0DATE:
06/23/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Robert C.CantoriaTIME COMPLETED:
10:55 AM
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Licensing Program Analyst (LPA) Bernadette Allen conducted an announced visit to the facility for the purpose of a pre-licensing inspection. At 9:29 LPA arrived at the facility and met with Robert C.Cantoria. To conduct a second (2) pre-licensing inspection from 4/28/2022 to inspect and confirm that all corrections have been made.

The pending application is for two (4) non-ambulatory clients in a Residential Facility Care for Elderly. LPA Allen toured the facility inside and out. The following was observed, reviewed, and inspected: There are four (4) client bedrooms and three (3) bathrooms. There are no bodies of water. The physical plant, in general, was in good repair. The buildings and grounds were free of hazards. Outdoor and indoor passageways were kept free of obstruction. The outside of the facility had a shaded area with seating for residents. LPA observed a chase cabinet with magnetic locks for medications to be stored. The facility has a designated area for client files, staff files, and P& I funds. During todays inspection the following corrections were observed.

LPA observe the emergency disaster plan, exit plan, personal rights, or complaint procedures posted. Emergency phone numbers, Let-Us-No poster, and client’s rights posted throughout prominent areas

LPA observe the 7 days supply of non-perishable food and emergency kits. LPA observe clearing solutions & poisons in locked stored area in the kitchen. LPA observe non-slip mats protection in all three (3) bathrooms bathtubs/showers. LPA observe night lights throughout hallways in non-private bathrooms area. LPA observe additional paper towels, toilet paper or cleaning supplies in the closet in the main hallway near clients bedrooms. LPA measured hot water temperature at 107.7 degrees F. smoke alarms, and carbon monoxide detectors are in working conditions

...................................................Continued on LIC809C

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: ALL ABOUT CARING HOME 1
FACILITY NUMBER: 331881300
VISIT DATE: 06/23/2022
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LPA observe the required bedding for the client bedrooms. LPA observe sufficient supply of clean linen, including blankets, bedspreads, top and bottom sheets, pillows, pillowcases, bath, hand, and wash towels to permit changing weekly or as needed.

LPA observe activity supplies /equipment variety of reading materials such as magazines, newspapers. LPA observe an operating facility telephone and menu's for residents.

An exit interview was conducted, and a copy of this report LIC 809 and LIC809C was discussed and provided to the Administrator Robert C.Cantoria.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC809 (FAS) - (06/04)
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