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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593365
Report Date: 02/21/2023
Date Signed: 02/21/2023 02:59:21 PM

Document Has Been Signed on 02/21/2023 02:59 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: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: 12DATE:
02/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:John NguyenTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required-1 year visit focusing on COVID-19 Infection Control Practices. LPA met with John Nguyen. LPA explained the purpose of today's visit. There are (12) clients on-site and (27) are receiving remote programming. This program provides services for developmentally disabled clients (ages 18-59) from various Regional Centers. Currently, there are (41) clients from Eastern Los Angeles Regional Center, (4) clients from Frank D. Lanterman Regional Center and (4) from San Gabriel Pomona Regional Center.

This facility consists of: There is (1) sensory motor room (detached building), (4) bathrooms, (1) activity room, (2) designated rooms for clients experiencing symptoms (awaiting for pick up) and administrative offices.

The following were observed/inspected:
  • COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility and throughout the facility.
  • Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing were observed.
  • PPE observed.
  • Clients bring their own lunch and/or snacks. Facility provides storage/refrigeration.
  • Clients bring medication to the program which is kept stored/locked at a supervisor's office. There are currently (11) clients taking medication during programming hours.
  • Clients have cubbies to store their belongings.
  • Restrooms have hand soap, hand sanitizer and paper towels.
  • Staff responsible for direct care and supervision were wearing masks.
  • Clients were be socially distanced according to local public health guidelines.
Exit interview conducted, a copy of this report and Appeal Rights were provided to John Nguyen.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Elizabeth Irra
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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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