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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593365
Report Date: 03/11/2022
Date Signed: 03/11/2022 02:08:43 PM

Document Has Been Signed on 03/11/2022 02:08 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:CLIMB WORK ACTIVITY CENTER-ALHAMBRAFACILITY NUMBER:
191593365
ADMINISTRATOR:ACABAL, MARILYNFACILITY TYPE:
775
ADDRESS:2300 WEST MAIN ST.TELEPHONE:
(626) 289-5321
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: 50CENSUS: 20DATE:
03/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:John Nguyen, Program DirectorTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection with the focus of the infection control domain. LPA arrived unannounced and met with John Nguyen, Program Director. The purpose of the visit was explained. The day program is licensed to serve 50 developmentally disabled adults, ages 18-59.

LPA Chan toured the facility with Staff and observed the following:
* The day program consists of one single story building comprised of administrative offices and several rooms. LPA observed 3 of the rooms in the main building being used as a resting or changing area for clients, and a dining room being used for activities. There is a detached building called the sensory room with 2 bathrooms and a trailer to the side of the main building with 3 rooms, all used to conduct activities with clients. The middle outdoor space is shaded with tables and chairs. Clients bring their own food and snacks to program and are stored in the refrigerator. Medications are brought to the program daily and are stored and locked in the file cabinet. Cubbies are located by the washing machines. Disinfectants and cleaning solutions are locked and not accessible to clients. The hot water temperature is measured between 105-120 degree F. The fire extinguishers were last inspected on 5/18/21. The smoke/carbon monoxide combo detectors are operable in the sensory room and trailer.
* The day program is currently following the COVID-19 recommendations. LPA observed signage posted throughout the facility for hand washing, social distancing, and for masks. LPA recommended to add more cough/sneeze etiquette signs around the facility. Adequate PPE supplies for more than 30 days were observed in the storage room. No staff or client files were reviewed today.

No deficiencies were issued. Exit interview was conducted and a copy of this report along with appeal rights were given.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2022
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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