191601509-3-15-2023-11-AS-WGIS-CPXSKL-20230315135654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191601509
Report Date: 03/15/2023
Date Signed: 03/15/2023 01:57:03 PM

Document Has Been Signed on 03/15/2023 01:57 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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	HARRY A MIER CENTER		FACILITY NUMBER:	191601509
ADMINISTRATOR:	LIM, JAE W		FACILITY TYPE:	775
ADDRESS:	8090 CRENSHAW BLVD		TELEPHONE:	(323) 753-3101
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90305
CAPACITY: 27		CENSUS: 15	DATE:	03/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:49 AM
MET WITH:	La Niece Randolph		TIME COMPLETED:	02:00 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	On 03/15/2023, Licensing Program Analyst (LPA) Wendy Gibbs, conducted an unannounced annual required visit. LPA spoke with staff via telephone to conduct the covid-19 screener and was informed the facility is free of Covid-19. LPA met with Program Supervisor La Niece Randolph and explained the purpose of today’s visit. The facility is licensed to serve (23) ambulatory and (4) non-ambulatory clients. Currently there are 15 clients present during today's visit. The facility has a 1 to 3 ratio. Structure The day program is a single-story structure located in a commercial building. Facility grounds consist of the following: Lobby, administrative offices, two (2) activity rooms, first aid room, commercial kitchen, conference room, copy/supply room, seven (7) client restrooms and two (2) staff restrooms and indoor pool in a detached building. Physical Plant LPA and Program Supervisor toured the physical plant. There is a large, gated grass area in the front of the facility, a covered patio area, between the two (2) buildings, with table and chairs and two (2) storage boxes full of outdoor activities. There is an indoor pool on the grounds, outside of the gated area in a detached building inaccessible to residents. Lifeguard is present during operating hours and doors are securely locked. The clients do have activities in the pool throughout the week such as water aerobics. All walkways were clean, clear, and free of obstructions, debris, or hazards. Common Rooms Both activity rooms were observed to be neat, clean, and appropriately furnished to accommodate all clients. One activity room had four (4) bathrooms and the other activity room has three (3) bathrooms and a laundry room. Bathrooms were found to be within Title 22 regulations and were clean and operational. All safety handrails were securely fastened. LPA observed all bathrooms were fully stocked with hand soap and paper towels. Additional supply was secured in a locked utility room. LPA observed the facility to be sanitary and appropriately furnished at the time of visit.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HARRY A MIER CENTER	FACILITY NUMBER: 191601509
	VISIT DATE: 03/15/2023

NARRATIVE

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Kitchen LPA observed the kitchen to be neat, clean, and organized. All appliances were clean and in good working repair. LPA observed an ample supply of cutleries, pots, and pans in good working repair. All sharps were secured in a locked drawer in the kitchen and inaccessible to clients. LPA observed a 2-day supply of perishable foods and a 7-day supply of nonperishable foods. All food was stored properly and labeled. The water temperature measured 105.6-degrees Fahrenheit.
Safety LPA observed all exits are clearly marked. The facility sketch with exit routes were posted throughout the facility. LPA observed multiple fire extinguisher fully charged and last serviced on 01/11/23. The smoke detectors and sprinkler system were last inspected by Los Angeles Fire Department in December 2022. The last emergency drill was conducted on 01/21/23 and is discussed routinely with clients weekly. LPA observed a Carbon Monoxide detector in the hallway by the administrative offices and in the two (2) activity rooms. In the First Aid room, LPA observed a cabinet and kit fully stocked of the required items and a manual. There is First Aid kits to go on outings as well. LPA observed all required licensing documents posted. All cleaning supplies, and toxins were stored in the secured utility closet between staff restrooms and inaccessible to clients.
Infection Plan During the visit, LPA observed the facility infection control practices. LPA reviewed screening protocol for visitors, staff, and clients. There are sanitizing stations in common areas and restrooms. LPA observed the facility has a 90-day supply of Personal Protective Equipment (PPE). All mandated infection control posters were posted and available. LPA observed all staff wearing face masks.
Medications All medications are stored in a locked drawer in the First Aid room and are inaccessible to clients. LPA reviewed the client’s medications and matched them to the MARs.
File Review LPA reviewed five (5) client files and found they contained the required documents. LPA reviewed five (5) staff files and found the contained the required documents, certification, and training. LPA interviewed 3 clients, and all are happy at the facility. LPA interviewed 3 staff, and all were able to answer all questions and describe the process and/or information.

No deficiencies were cited during this inspection visit.

An exit interview was conducted, and a hard copy of this report was provided to Program Supervisor La Niece Randolph.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

LIC809 (FAS) - (06/04)

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