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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191502401
Report Date: 06/14/2022
Date Signed: 06/14/2022 05:37:28 PM

Document Has Been Signed on 06/14/2022 05:37 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: 31DATE:
06/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Christina Salazar, Site CoordinatorTIME COMPLETED:
05:30 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 met with Christina Salazar and explained the purpose of the visit. The day program is approved to serve 100 ambulatory and 45 non-ambulatory adults. The day program is currently open for in person sessions with a hybrid system in place to mitigate the spread of the Coronavirus.

LPA Chan toured the facility and observed/inspected the following:
* Staff and visitors check in on the side door of the front building which consists mainly of the Administrative offices. Staff fill out the screening questionnaire prior to entering the building. Clients check in at the multi-purpose building next to the parking lot. Clients temperature are taken twice a day.
* The facility is currently utilizing the 3 classrooms towards the back of the facility.
* Hand sanitizers are availabl in each of the rooms.
* Covid-19 signage were observed throughout the facility and in the bathrooms.
* Disinfectants/cleaning solutions are locked, making them inaccessible to clients.
* Classrooms are set up with social distancing.
* PPE supplies of at least 30 days are maintained at the program.
* Medication are dispensed and documented when given by staff.
* The fire extinguishers were last inspected on 8/5/21.
* Staff are cleaning often and tables are disinfected after each use.
* The facility conducts surveillance testing every Friday for staff and for any clients who want to participate.
* The day program is continuing to follow the strictest COVID-19 guidance.

No deficiencies issued today. An exit interview was conducted and a copy of this report was provided to the the Coordinator.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2022
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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