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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320377
Report Date: 09/04/2026
Date Signed: 09/04/2026 03:33:45 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/04/2026 03:33 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:VENETIAN GARDEN GUEST HOMEFACILITY NUMBER:
198320377
ADMINISTRATOR/
DIRECTOR:		GRANETA, NORMA R.FACILITY TYPE:
740
ADDRESS:22706 MARINE AVENUETELEPHONE:
(562) 414-2853
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY: 6CENSUS: 6DATE:
09/04/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:36 AM
MET WITH:Norma GranetaTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
NARRATIVE
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On 09/04/26 at approximately 8:00 AM, Licensing Program Analyst (LPA) Jose Anguiano conducted an unannounced annual required visit. LPA met with Licensee/Administrator Norma Graneta and explained the purpose of the visit. The facility is licensed to serve six (6) elderly residents, ages 60 and above, of which one (1) may be bedridden in Room #4 only. The facility is approved for four (4) hospice residents. No residents are currently in Hospice care.

The facility is a single-story structure located in a residential neighborhood. The facility consists of four (4) resident bedrooms, two (2) common bathrooms, a living area, dining area, kitchen, and an outdoor seating area.

LPA and the Administrator toured the physical plant. There were no bodies of water observed on the premises. All resident rooms were inspected. Beds and bedding were observed to be in good condition, adequate lighting was provided, and storage for residents' personal belongings was available. Bed linens, comforters, and bath towels were adequately stocked at the time of the visit.

The bathrooms were clean and operational. Water temperatures measured between 130°F and 131°F in two resident bathrooms, which exceeded the allowable range. The facility maintained an indoor temperature of approximately 77°F.

LPA observed the facility to be sanitary and appropriately furnished at the time of the visit.

Please see report (LIC809-C) for report continuation.

Ulysses Coronel
Jose Anguiano
DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/04/2026
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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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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Document Has Been Signed on 09/04/2026 03:33 PM - It Cannot Be Edited


Created By: Jose Anguiano On 09/04/2026 at 12:16 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: VENETIAN GARDEN GUEST HOME
FACILITY NUMBER: 198320377

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/05/2026
Section Cited
CCR
87303(e)(2)

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87303 Maintenance and Operation (e) Water supplies...(2) Faucets used by residents...Hot water temperature controls shall be maintained...a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C).
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The Licensee/Administrator shall adjust the water heater to ensure hot water accessible to residents is maintained between 105°F and 120°F. The Licensee/Administrator shall measure and document the water temperature in resident bathrooms and submit proof of correction to CCL by the POC due date.
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This requirement is not met as evidenced by: Based on observation, LPA measured the hot water temperature in two resident bathrooms between 130°F and 131°F. The licensee failed to ensure that hot water accessible to residents was maintained between 105°F and 120°F, which poses an immediate health and safety risk to residents in care.
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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.
Ulysses Coronel
NAME OF LICENSING PROGRAM MANAGER:
Jose Anguiano
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/04/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/04/2026


LIC809 (FAS) - (06/04)
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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: VENETIAN GARDEN GUEST HOME
FACILITY NUMBER: 198320377
VISIT DATE: 09/04/2026
NARRATIVE
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Personal hygiene items, cleaning supplies, toxins, and sharp objects were stored and inaccessible to residents. The kitchen was inspected and sufficient perishable and nonperishable food was observed and properly stored.

The fire extinguisher was last charged on 03/22/23, see (LIC9102) Technical Assistance (TA) for additional information. Smoke detectors and carbon monoxide detectors were tested and found operational. LPA reviewed Medication Administration Records (MARs), which were found complete and accurate. A landline telephone was operational. LPA reviewed five (5) resident files and three (3) staff files, which were found complete.

During the visit, LPA observed the facility's infection control practices, including screening protocols and sanitizing stations in common areas and restrooms. The facility maintained an approximately 30-day supply of Personal Protective Equipment (PPE). All required postings were observed to be posted and available at the facility.

LPA observed that the First Aid Kit was maintained. LPA reviewed liability insurance policy which expires on 08/08/27. The facility was current on Community Care Licensing annual fees dated 08/26/26.

Deficiencies were cited during today's visit: Please see LIC809-D and LIC9102 (TA/TV) for additional information.

The fire extinguisher was last charged on 03/22/23.

LPA observed that the sliding screen door located in one resident bedroom was difficult to open and did not slide properly.

LPA also observed that the black sliding gate located at the exterior entrance was heavy and difficult to open due to rust observed on the wheels and metal sliding track.

Additionally, the auditory alert on an exterior exit door did not activate when the door was opened or closed.

Water temperatures measured between 130°F and 131°F in two resident bathrooms, which exceeded the allowable range.

An exit interview was conducted with Licensee/Administrator Norma Graneta. Appeal rights and a copy of this report was explained and provided.

NAME OF LICENSING PROGRAM MANAGER: Ulysses Coronel
NAME OF LICENSING PROGRAM ANALYST: Jose Anguiano
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
LIC809 (FAS) - (06/04)
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