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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191570094
Report Date: 08/04/2023
Date Signed: 08/04/2023 04:05:28 PM

Document Has Been Signed on 08/04/2023 04:05 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:DAY TRAINING ACTIVITY CENTERFACILITY NUMBER:
191570094
ADMINISTRATOR:SOSA, EMILIOFACILITY TYPE:
775
ADDRESS:9555 WASHBURN RD.TELEPHONE:
(562) 803-3391
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY: 65CENSUS: 9DATE:
08/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:26 PM
MET WITH:Emilio Sosa - CEOTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Tena Herrera conducted an Annual/Required visit. LPA arrived unannounced and met with Chief Executive Officer (CEO) Emilio Sosa and explained the reason for the visit. The facility is licensed to serve 58 Ambulatory and 7 Non-Ambulatory developmentally disabled adults ages 18 and above.

The facility is located in an industrial area in Downey Ca. There are 4 activity rooms, 1 computer room, 2 storage rooms, 5 offices, 1 women's restroom with 3 stalls, 1 men's restroom with 2 urinals and 2 stalls, 2 staff restrooms, staff lounge area and reception area.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:
Infection Control: The facility staff are using appropriate hand hygiene while assisting clients’. Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan.
Physical Plant and Environmental Safety: There are carbon monoxide detectors and fire alarms that are in compliance and operable. Facility is clean, safe, sanitary and in good repair. Disinfectants, cleaning solutions and other items that could possibly pose danger to clients are centrally stored in locked cabinets and locked storage rooms.
Operational Requirements: Facility maintains an approved fire clearance. Staff are knowledgeable on reporting requirements of abuse.
Staffing: There seems to be sufficient staffing in facility during hours of operation.
Personnel Records-Training: Staff have proper criminal clearance, ongoing training and health screening on file. Administrator has all needed training and certificates on file. Personnel files are kept locked in a secure location within the facility.
Client Records-Incident Reports: Client files are kept in a secured location and have the following documents in their files - Admission Agreements, Identification & Emergency Information, current Physician's Report, Pre-admission appraisal/Appraisal Needs & Services Plan.
(Continued on 809-C)
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: DAY TRAINING ACTIVITY CENTER
FACILITY NUMBER: 191570094
VISIT DATE: 08/04/2023
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Client Rights-Information: The facility has Personal Rights Poster posted. There are no clients in care that are in need of any postural supports.
Food Service: Clients bring their own food in lunch bags and are stored away from any toxic substances.
Health-Related Services: Staff that have direct contact with clients have their proper CPR training on file.
Incidental Medical Services: Staff have proper training to meet the needs of clients in care.
Disaster Preparedness: There is a emergency disaster and mass casualty plan readily available at the facility that includes transportation arrangements, evacuation procedures, local emergency contact information and emergency shut off valve locations.
Emergency Intervention: Clients at this facility do not require the use de-escalation techniques.

LPA conducted 3 staff interviews and 5 client interviews during today’s visit.

Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were observed during today’s visit.

Exit interview was held and a copy of the report was provided CEO Emilio Sosa.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
LIC809 (FAS) - (06/04)
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