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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191502401
Report Date: 01/11/2022
Date Signed: 01/11/2022 03:43:18 PM

Document Has Been Signed on 01/11/2022 03:43 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:MERCI SCHOOLFACILITY NUMBER:
191502401
ADMINISTRATOR:MARTA ESCANUELASFACILITY TYPE:
775
ADDRESS:525 AND 527 NORTH CHANDLERTELEPHONE:
(626) 289-8817
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91754
CAPACITY: 145CENSUS: 35DATE:
01/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Christina Salazar, Site CoordinatorTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection with the focus of the infection control domain. LPA arrived unannounced and met with Christina Salazar to explain the purpose of the visit. The day program is approved to serve 100 ambulatory and 45 non-ambulatory adults. There are currently no clients at the premises today and staff are providing services remotely.

LPA Chan toured the facility and observed or inspected the following:
* Staff and visitors check in on the side door of the Administrative office. Temperature and screening questionnaire are filled out before entry. Clients check in at the back classroom next to the parking lot. Clients temperature are taken twice a day.
* Staff utilize 6 of the 10 classrooms for consumers activities when program is open for in person services. The 4 classrooms to the left of the building entrance are used as storage. Extra supplies of PPE and hygiene are stored in those rooms.
* The facility is well maintained and LPA did not observed any obstructions to the walkways.
* Cleaning solutions are locked, making inaccessible to clients.
* The hot water temperature is measured between 105-120 degree F.
* The fire extinguisher was last inspected on 8/5/2021. Smoke detectors are hard wired and are operational.
* The day program is currently following the COVID-19 recommendations. LPA observed signage posted for hand washing, symptoms check, and social distancing. Hand sanitizers and masks are available throughout the facility, and adequate PPE supplies for at least 30 days.
* Staff break rooms have appropriate signage for precautionary measures.

There are no deficiencies issued during the visit today. Exit interview conducted and a copy of this report and appeal rights were given.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2022
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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