<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191592637
Report Date: 01/24/2023
Date Signed: 01/24/2023 05:15:40 PM

Document Has Been Signed on 01/24/2023 05:15 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:ADULT BASIC LEARNING ENVIRONMENT, INC.FACILITY NUMBER:
191592637
ADMINISTRATOR:MICHAEL MORALESFACILITY TYPE:
775
ADDRESS:452 W. BADILLO ST.TELEPHONE:
(626) 858-5267
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY: 30CENSUS: 0DATE:
01/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Miriam CuevaTIME COMPLETED:
01:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPA) Christine Wong conducted an unannounced annual visit at the facility. LPA met with Program Director Miriam Cueva - and explained the reason for the visit.

Facility is licensed to served WITH A MAXIMUM OF 30 NON-AMBULATORY DEVELOPMENTALLY DISABLED ADULTS, AGES 18 THROUGH 59. 13 WHEELCHAIRS PERMITTED ONLY. Facility is currently has no clients attend the day program either remotely or in person. Facility has a front desk, multipurpose room, storage room, relaxation room, program director office, changing room, kitchen, three client bathrooms, art room and a vocational room

LPA conducted a tour of the facility with the director and observed the following:
Restrooms water temperature were tested between 111.5 and 114.7 degrees F which is within the 105 - 120 degrees F. Facility has 3 fire extinguishers were observed throughout the facility.
Facility has one first aid kit which located on the wall between changing room and kitchen which contains the required items.. Knives and kitchen cleaning supplies are kept under lock under the kitchen sink which inaccessible to the clients.

Facility is currently has no client attend the day program either in person or remotely but facility is still following the recommendations regarding COVID 19 signs throughout the facility. The restrooms still have sufficient soap, paper towels and signs. PPE supplies are sufficient for more than 30 days.

No deficiencies were observed during the visit and exit interview conducted and a copy of the report was provided to Program Director Miriam Cuevas

(Due to no client attend the facility at this moment, no client was interviewed)
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christine Wong
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2023
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 1