South Bay Memory Care.

On 11/14/2025, the California Department of Social Services (CDSS) – Community Care Licensing Division (CCLD) Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Administrator, Kristine Simonian. The purpose of the visit was explained, and the LPA was allowed entry to the facility. This facility is licensed to serve 6 non-ambulatory adults ages 60 and above, of which 2 may be on hospice. A total of 5 residents are currently residing in this facility. Facility Layout: The facility is a one-story house located in a residential street. The home consists of 3 resident bedrooms, 3 full bathrooms, 1 toilet room, 1 office, 1 great room which includes the dining table and the living room area, 1 kitchen, 1 attached garage, and 1 backyard patio area with shaded seating. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Outside Grounds: were toured no bodies of water were observed, walkways around the home were clear of hazards, and there are no security bars or weapons on the premises. Kitchen Area/Facility Food: The facility has supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept inaccessible to residents in care. There is fire extinguisher in the kitchen, and it was last serviced on 01/02/2025. There is a landline telephone on the kitchen counter top. Living Room/Community Indoor Space: There is activity work (i.e. coloring materials) for residents in the living room area. Resident Bedrooms: 3 out of 3 resident bedrooms were toured. There is adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Bathrooms: Toilets, showers, and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries are accessible to residents. The hot water temperature measured 119 Fahrenheit. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Medications: were inaccessible to residents in care. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Medication Administration Records (MARs) were reviewed, and they were current and up to date. Garage: is used as a storage area for cleaning supplies, extra storage for residents, etc.; there is also a laundry area. Miscellaneous: Documents are posted as mandated. Last quarterly disaster drill was conducted on 09/12/2025. The last Annual Fire Inspection was completed on 01/02/2025 by the City of Torrance, Fire Department. The facility has a current liability insurance. Smoke and carbon monoxide detectors were in compliance and operational. 5 staff records were reviewed, 5 out of 5 staff records had required documentation. 5 resident records were reviewed, 5 out of 5 resident records had required documentation. No deficiencies are being cited based observation and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted, and a copy of this report was left with the Administrator, Kristine Simonian.

On 10/11/2024 at around 8:00 AM, Licensing Program Analyst (LPA) Leandro conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with the Administrator Kristine Simonian. LPA explained the purpose of the visit and was accompanied by a staff member inside and outside the facility during this inspection. This facility is licensed to serve 6 non-ambulatory adults ages 60 and above, of which 2 maybe on hospice. A total of 5 non-ambulatory residents are currently residing in this facility. The Annual Licensing Fees are current. The facility is a one-story house located in a residential street. The home consists of 3 resident bedrooms, 3 full bathrooms, 1 toilet room, 1 office, 1 living/dining room, 1 kitchen, 1 attached garage, and 1 backyard patio area with shaded seating. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Outside grounds were toured and no bodies of water were observed. The patio furniture is under a shaded area and accessible to residents. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. LPA toured the kitchen area and observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Knives and toxins were kept in locked storage cabinet. LPA observed that medications were safe, locked, and inaccessible. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last fire drill was conducted on 10/2024. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational. There are several fire extinguishers on the premises, and they were last serviced on 07/12/2024. There is a videoconferencing device dedicated for client use in the office. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 3 out of 3 resident’s bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. LPA tested hot water temperature and it measured between 105 and 120 degrees Fahrenheit. This facility provides residents with hygiene products such as nonmedicated soap, toilet paper, toothbrush, toothpaste, and comb. 5 staff records were reviewed, 5 out of 5 staff records had required documentation. 5 resident records were reviewed and, 5 out of 5 resident records had required documentation. No deficiencies are being cited based on LPA observation and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted and a copy of this report was left with the Administrator.

On 11/8/2023, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Rosselyn Fagaragan/Director. LPA explained the purpose of today’s visit. The facility is licensed to serve (5) residents ages 60 and above of which (6) non-ambulatory only. Facility has an approved hospice waiver for (2) patients. The facility is a single-story family home located in a residential neighborhood. The facility consisted of the following: Living room, dining area, kitchen, three (3) bedrooms, two (2) bathrooms, laundry area in the garage, indoor/outdoor activity area, shaded patio area, and attached two (2) car garage. LPA Iniguez toured the physical plant with director. There were no bodies of water or obstructions on the premises. A total of (3) rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. Bathrooms were found to be within Title 22 regulations and were operational. LPA inspected rooms: #1, #2, and #3 and smoke and carbon monoxide combo are all in operable conditions. The water temperature properly measured between 105°-120°F: Kitchen 114.9°F, Bathroom #1:113.1°F, Bathroom #2:112.4°F. Evaluation Report Continues LIC 809-C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA Iniguez observed the facility clean, sanitary and appropriately furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. All fire extinguishers were charged and were operable. A review of (3) residents' service files, (3) staff personnel files and (3) Medication Administration Records (MAR) were maintained in order. First AID kit was checked. Last fire disaster drill was on: 10/8/2023. LPA observed the facility's infection control practices. A copy of the liability insurance was provided to LPA during visit. 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 Rosselyn Fagaragan/Director.