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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191601509
Report Date: 02/23/2024
Date Signed: 02/26/2024 08:13:37 PM

Document Has Been Signed on 02/26/2024 08:13 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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:HARRY A MIER CENTERFACILITY NUMBER:
191601509
ADMINISTRATOR:LIM, JAE WFACILITY TYPE:
775
ADDRESS:8090 CRENSHAW BLVDTELEPHONE:
(323) 753-3101
CITY:INGLEWOODSTATE: CAZIP CODE:
90305
CAPACITY: 54CENSUS: 21DATE:
02/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:46 AM
MET WITH:Jae LimTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1- year visit with the primary focus on Infection Control measures and using the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the assessment, the facility is clear of COVID-19 infection. LPA was properly screened for COVID-19 symptoms and temperature was checked. LPA Bunker met Center Director Jae Lim and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved mitigation plan report and infection control plan. The facility is licensed to serve (50) ambulatory and (4) non-ambulatory clients aged 18 through 59. Currently, there are 21 clients present during today's visit. The facility has a 1 to 3 ratio. The Adult Day Program annual fees are current.

12 Domains in the Infection Control Practices will be observed and reviewed. "I will be using this tool and methods that have been developed to improve the efficiency and accuracy of the Department of Social Services' facility inspections."

The Adult Day Program is located in a single-story commercial business area, operating hours are 9:00 A.M. to 6:00 P.M. 5 days a week Monday through Friday. All clients bring their own lunch or bring money to purchase lunch in the community. If clients forget their lunch the facility staff will provide emergency food for clients.

The day program is a single-story structure located in a commercial building. Mr. Lim and LPA Bunker toured the entire Adult Day Program inside and out which consisted of the following: The Day Program consists of the following: Lobby, reception area, 5 administrative offices, two (2) activity rooms, medication/first aid room, commercial kitchen, conference room, mail room, staff lounge, seven (7) client restrooms and two (2) staff restrooms, 2 restrooms, and pump room, storage garages, and an outside shaded area with a gated parking lot. See continued LIC809-C on page #2
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: HARRY A MIER CENTER
FACILITY NUMBER: 191601509
VISIT DATE: 02/23/2024
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Continued LIC809-C page #2

There is an indoor pool on the grounds, with an office, outside of the gated area in a detached building inaccessible to residents. A 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 areas are in compliance. Each room is adequately equipped and furnished. The staff in-service training was reviewed. The employee personnel files and client records are in a locked cabinet in the administrative office and were reviewed and appear to be in compliance. Ms. Lim states staff was given training on dependent adult and elder abuse reporting videos. The day program currently has two clients on medication. The medications are in a locked cabinet in the medication room. There are no personal/incidental monies handled by the day program staff. The last Fire/Emergency Drill was conducted on February 02, 2024

During the visit, LPA observed the facility's infection control practices. LPA reviewed the 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).

Documents are posted as mandated in the program activity rooms. The following Title 22 regulated areas were audited and found to be in compliance: Hot water temperature measured at 113.8 degrees Fahrenheit, carbon monoxide and smoke detectors were in compliance, fire extinguishers are fully charged, rest-rooms are clean and operational, toxic/sharp items locked inaccessible to clients. Hazardous items are inaccessible to clients and the first aid kit is fully stocked with manual. The day program grounds are free of debris/hazards.

There were no deficiencies cited.

Exit interview conducted.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
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