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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198203121
Report Date: 06/18/2026
Date Signed: 06/18/2026 04:56:09 PM

Document Has Been Signed on 06/18/2026 04:56 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:JOSEPHINES GARDEN VILLAFACILITY NUMBER:
198203121
ADMINISTRATOR/
DIRECTOR:		FRANCES REEDERFACILITY TYPE:
740
ADDRESS:521 N. ROWELL AVENUETELEPHONE:
(310) 376-5758
CITY:MANHATTAN BEACHSTATE: CAZIP CODE:
90266
CAPACITY: 6CENSUS: 6DATE:
06/18/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Rissa Angenrani (Caregiver)TIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On 06/18/2026 at 1230pm, the Department conducted an unannounced required Annual visit with a primary focus on infection control. Licensing Program Analyst (LPA) Zina Brown was met by caregiver Rissa Angenrani. Administrator France Reeder was not available to be at the facility and was notified by telephone of the visit. The facility is licensed for adults 60 years and over for (6) non-ambulatory residents. Facility is approved for (2) hospice residents and currently has (1) residents in hospice care.

The facility has a administrator certification for Frances Reeder #7007037740 valid 12/01/2024 - 11/30/2026. The facility fees are current and paid in full. The facility has liability insurance with Kinsale Insurance Company with each occurrence at $1,000,000 and general aggregate at $3,000,000 which is valid from 03/22/2026 - 03/22/2027. The facility last fire and earthquake safety drill was conducted on 03/16/2026.

The facility is a single-story structure with a ramp and front porch located in a residential neighborhood. The facility consist of (6) resident rooms, (1) staff room, (3) full bathrooms, kitchen, living / dining room, and patio area.

Between the hours of 12:55pm - 1:10pm, the Department and caregiver Angenrani toured the physical plant. There are no bodies of water or on the premises. All resident rooms were checked. Beds and bedding were in good condition, adequate lighting provided, storage for resident's personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were clean and operational. The water temperature measured at (120.F in 1 half bathroom/ 2 full bathroom/den area, 119.8 in kitchen, 118.9 in half bathroom and 116.6F in full bathroom).

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Zina Brown
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2026
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 5
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: JOSEPHINES GARDEN VILLA
FACILITY NUMBER: 198203121
VISIT DATE: 06/18/2026
NARRATIVE
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A comfortable temperature is maintained in the facility. LPA observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to resident. The kitchen was inspected and there is enough perishable and non-perishable food available which is stored properly. Fire extinguisher was charged, smoke detectors and Carbon Monoxide were operable.

Between the hours of 1:15pm - 3:30pm the Department conducted a records review of (6) residents records, (5) staff records and (6) Record Medication Administration Records.

During today's visit the Department did observe deficiencies.

DEFICIENCIES:
  • Resident 1 (R1), Resident 3 (R3), Resident 4 (R4) and Resident 6 (R6) has half bed rails with no is not on hospice care nor had physician's orders for bed rails.
  • Administrator did not have personnel file available at the time audit for review for Staff 1 which is the Adminstrator.
  • Staff #5 no associated to the facility in Guardian nor LIS.

As a result, civil penalties are being assessed and a deficiencies are being cited under California Code of Regulation Title 22, Division 6, Chapter 8 are being cited on the LIC 809-D.

Exit interview held with Rissa Angenrani. A copy of the report, deficiencies, civil penalties, and appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Janae Hammond
NAME OF LICENSING PROGRAM ANALYST: Zina Brown
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 06/18/2026 04:56 PM - It Cannot Be Edited


Created By: Zina Brown On 06/18/2026 at 04:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: JOSEPHINES GARDEN VILLA
FACILITY NUMBER: 198203121

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87608(a)(3)
87608 Postural Supports: (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above for 4 out of 6 residents which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/09/2026
Plan of Correction
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The licensee will obtain a written order from a physician indicating the need for the postural support for the following Residents: R1, R3, R4, and R6 and submit proof to the department via email Zina.Brown@dss.ca.gov by POC due date.

Type B
Section Cited
CCR
80066(a)(1-11)
Licensee must maintain complete personnel records for the licensee, administrator, and all employees. Records shall include: employee name; driver’s license if transporting clients; date of hire; age statement; home address/phone; documentation of required education, training, and experience; past employment; job duties; termination date; health screening; and TB test results.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/02/2026
Plan of Correction
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The licensee will submit proof of Administrator file which should include the LIC 501, LIC 503, First Aid/CPR and submit proof to the department via email Zina.Brown@dss.ca.gov by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Janae Hammond
NAME OF LICENSING PROGRAM MANAGER:
Zina Brown
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/18/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/18/2026 04:56 PM - It Cannot Be Edited


Created By: Zina Brown On 06/18/2026 at 04:27 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: JOSEPHINES GARDEN VILLA
FACILITY NUMBER: 198203121

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87355(e)(2)
Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2)Obtain a California clearance or a criminal record exemption as required by the Department

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, Nelly Drugan is not associated to the facility as the time of unannounced annual inspection which poses an immediate health, safety or personal rights risk to persons in care.

POC Due Date: 06/19/2026
Plan of Correction
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The facility shall associate Nelly Drugan in Guardian and submit proof of update via email at zina.brown@dss.ca.gov by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Janae Hammond
NAME OF LICENSING PROGRAM MANAGER:
Zina Brown
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/18/2026


LIC809 (FAS) - (06/04)
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