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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593145
Report Date: 03/01/2024
Date Signed: 03/01/2024 04:20:59 PM

Document Has Been Signed on 03/01/2024 04:20 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:NEW DAY ASSISTED LIVINGFACILITY NUMBER:
191593145
ADMINISTRATOR:CRUZ, JUANFACILITY TYPE:
735
ADDRESS:9555 RAMONA STTELEPHONE:
(562) 867-1002
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 29CENSUS: 17DATE:
03/01/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Juan Cruz, Administrator TIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Galarza conducted an unannounced Annual Continuation visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to Administrator Juan Cruz. The facility is licensed for ambulatory only mentally disabled residents ages 18-59. The facility formerly known as "Ramona Guest Home - Bellflower" had a change of management company and Administrator change that was effective 1/16/2024. A change of ownership application was submitted and is pending. NOTE: Some Type A citations were issued on 2/13/2024.

The following 12 (CARE) tool domains were utilized during the inspection:

Infection Control:

  • Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor screening station located in the security guard outside courtyard area. An Infection Control Plan has been developed and was reviewed.

Physical Plant/Environment Safety:
  • The facility is located in a residential area and has 3 single structure buildings with 15 client bedrooms, 2 live-in staff living in 2 boiler rooms, 9 bathrooms, kitchen, dining room, living room, activities room, and outdoor courtyard area. There are Fully charged fire extinguishers were observed throughout the facility.

  • The Fire Department tested smoke detectors in October 2023 and yesterday Fire Alarm company tested the smoke detectors and checked the sprinkler system, fire panel, and all rooms. There are 4 carbon monoxide detectors.

  • The rear building pantry room/electrical room has paint cans, and other hazardous materials.

  • On 2/13/2024, there were discarded mattresses, chairs, wood planks, shopping carts, and bags of trash in the rear patio area, and the rear of the 3rd building,
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: NEW DAY ASSISTED LIVING
FACILITY NUMBER: 191593145
VISIT DATE: 03/01/2024
NARRATIVE
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Operational Requirements:
  • Care and supervision to meet the clients’ needs was observed.
  • LA County Fire Department has the facility under a Fire Watch order because the fire alarm system is not working, and the fire panel needs to be updated.
  • Surety bond of $4,000.00 is current.

Staffing:
  • A total of 8 staff members provides care and supervision to the clients.

Personnel Records/Staff Training:
  • Administrator certificate expires 3/21/2025.
  • All staff now have criminal background clearance and training.
  • Six (6) staff files were reviewed. Recent staff training conducted was on file, and all staff have current 1st Aid/CPR training.

Client Rights/Information:
  • Physician orders and personal rights are on file.

Client Records/Incident Reports:
  • Seven (7) client files were reviewed containing admission agreements, Physician's Report, medical/functional assessments, Appraisal/ Needs and Services Plans, TB clearance, Functional Capability Assessment, Psychiatric Evaluations, personal rights, medical consent, medication records, and P & I records were reviewed.
  • Residents (R3 & R7) did not have accurate amount of P & I monies, R3 was missing $10.00 & R7 was missing $100.00.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024
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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: NEW DAY ASSISTED LIVING
FACILITY NUMBER: 191593145
VISIT DATE: 03/01/2024
NARRATIVE
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Food Service:
  • The kitchen was inspected and has a sufficient supply of 2-day perishable & 7-day non-perishable food. The kitchen, food preparation area, and storage areas were observed to be clean and sanitary.
  • Physician orders for modified diets are on file.

Health Related Services:
  • Clients are assisted with self-administration of prescription and non-prescription medications.

Incident Medical and Dental:
  • Clients do not have prohibited health conditions or restricted health care plans. No hospice waiver is in place.

Disaster Preparedness, and Emergency Intervention:
  • Emergency Disaster Plan LIC 610D containing emergency evacuation, storage and preservation of medications, operation of manual assist devices was reviewed.
  • The facility shall conduct a drill at least quarterly for each shift. The facility did not have quarterly drill documents, new TM has not conducted a drill yet.
  • The facility has a First Aid Kit and Manual.

Emergency Intervention:
  • No manual restraints or seclusion are used with clients in care.

Per California Code of Regulations, Title 22, deficiencies were cited.

Exit interview conducted with Juan Cruz. A copy of the report and appeal rights were issued.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024
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Document Has Been Signed on 03/01/2024 04:20 PM - It Cannot Be Edited


Created By: Noemi Galarza On 03/01/2024 at 02:39 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
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: NEW DAY ASSISTED LIVING
FACILITY NUMBER: 191593145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
80020(a)
Fire Clearance
(a) All facilities shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that the facility is under a Fire Watch order because the fire alarm system was not working, and the fire panel needs to be updated in order to have Fire Dept communication, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/02/2024
Plan of Correction
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Administrator shall submit a written POC that includes the Fire Department plans. Once the Fire Department conducts the follow-up visit, submit the report to CCL.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Lisa Hicks
LICENSING EVALUATOR NAME:Noemi Galarza
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2024


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Document Has Been Signed on 03/01/2024 04:20 PM - It Cannot Be Edited


Created By: Noemi Galarza On 03/01/2024 at 02:39 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
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: NEW DAY ASSISTED LIVING
FACILITY NUMBER: 191593145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80087(a)
Building and Grounds
(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that on 2/13/2024, there were discarded mattresses, chairs, wood planks, shopping carts, and bags of trash in the rear patio area, and the rear of the 3rd building, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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Administrator shall submit picture proof that all items listed above have been discarded.
Type B
Section Cited
CCR
85087(a)(3)
Building and Grounds
(3) No room commonly used for other purposes shall be used as a bedroom for any person.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that 2 live-in staff (S4 & S5) are living in the front structure boiler room and in the middle structure boiler room, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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Temporary Manager shall relocate S4 & S5. Submit a written plan of correction.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lisa Hicks
LICENSING EVALUATOR NAME:Noemi Galarza
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2024


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Document Has Been Signed on 03/01/2024 04:20 PM - It Cannot Be Edited


Created By: Noemi Galarza On 03/01/2024 at 02:39 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
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: NEW DAY ASSISTED LIVING
FACILITY NUMBER: 191593145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80026(h)
Safeguards for Cash Resources, Personal Property and Valuables
(h) Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that residents (R3 & R7) did not have accurate amount of P & I monies, R3 was missing $10 & R7 was missing $100 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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Administrator stated that he will speak to former Administrator Stanley Kaniel and residents to determine where the discrepancy is in the monthly P & I ledgers. If it is determined that the amounts are inaccurrate or missing R3 & R7 need to be reimbursed.
Type B
Section Cited
HSC
1565(c)
Other Provisions
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of individuals served by the facility is not required during a drill. While a facility may provide an opportunity for individuals served by the facility to participate in a drill, it shall not require that participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and, if applicable, the names of staff participating in the drill.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that the facility did not have quarterly drill documents, new TM has not yet conducted a drill, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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Administrator shall submit proof that an emergency drill was conducted.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lisa Hicks
LICENSING EVALUATOR NAME:Noemi Galarza
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2024


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Document Has Been Signed on 03/01/2024 04:20 PM - It Cannot Be Edited


Created By: Noemi Galarza On 03/01/2024 at 03:29 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
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: NEW DAY ASSISTED LIVING
FACILITY NUMBER: 191593145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
85088(f)(1)(B)
Fixtures, Furniture, Equipment, and Supplies
(1) In all facilities with a licensed capacity of 16 or more clients, and all facilities having separate floors or separate buildings without full-time staff there shall be a signal system which has the ability to meet the following requirements: (B) Transmission of a visual and/or auditory signal to a central location, or production of an auditory signal at the client's living unit which is loud enough to summon staff.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that the facility does not have an operable visual and/or auditory signal system in place and there are 3 separate building structures in the premises, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 03/02/2024
Plan of Correction
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Administrator agreed to submit a written POC that states how the deficiency will be corrected.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Lisa Hicks
LICENSING EVALUATOR NAME:Noemi Galarza
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2024


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