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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197601136
Report Date: 01/31/2022
Date Signed: 01/31/2022 01:04:16 PM

Document Has Been Signed on 01/31/2022 01:04 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:BCR "A PLACE TO GROW"FACILITY NUMBER:
197601136
ADMINISTRATOR:EDWARD PARKER, JR.FACILITY TYPE:
775
ADDRESS:230 E. AMHERST DR.TELEPHONE:
(818) 843-4907
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 60CENSUS: 6DATE:
01/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Administrator Edward Parker, JR.TIME COMPLETED:
01:10 PM
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Licensing Program Analysts (LPA) Nune Margaryan conducted an unannounced Required - 1 Year annual inspection visit with the focus of the infection control domain. LPA met with Administrator Edward Parker, JR and explained the purpose of the visit. The program is vendorized through the Frank D. Lanterman Regional Center. This day program is licensed for 60 ambulatory Developmentally Disabled Adults, ages 18 through 59. There are 6 clients attending the program today.

At 9:10 am LPA Nune Margaryan toured the facility with Administrator and observed the following:


The program is housed in a single story structure along a semi-heavy traffic avenue, with its own parking lot and consists of a reception area, three offices, three storage rooms, five program breakout rooms, locker area for client personal storage, kitchen, 4 bathrooms (2 for staff and 2 for clients) and a shaded patio area.
There is one central entry point that has been designated to screen all clients, staff, and visitors. A check-in station is set up by the entrance and routine symptom screening is initiated at entry.

Facility has furniture organized to comply with social distancing and to meet the clients needs. All required signs regarding COVID-19 were observed. Facility has sufficient PPEs and appropriate cleaning supplies. The sinks have appropriate hygiene items and paper towels. The bathrooms are clean and have the required hygiene supplies and grab bars. The hot water temperature was tested in the bathrooms for clients and reading was 98.7 degree F. The outside area has a shaded sitting area. LPA did not observe any obstructions to the walkways nor any bodies of water. The first-aid kit is fully stocked w/First-Aid Manual, thermometer, scissors, tweezers, bandages and sterile first-aid dressing. Fire extinguishers located throughout the facility which were fully charged.


The kitchen was inspected at 9:50 am. LPA observed cleaning solution under the sink was not locked or inaccessible to clients.
Continued 809C






SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2022
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: BCR "A PLACE TO GROW"
FACILITY NUMBER: 197601136
VISIT DATE: 01/31/2022
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Clients' records were reviewed to confirm emergency contact is updated. Staff roster was reviewed to confirm all current staff have fingerprint clearances and are associated to the facility.


The deficiency cited is documented on the attached 809D. A copy of the report and appeal rights were provided to Administrator.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022
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Document Has Been Signed on 01/31/2022 01:04 PM - It Cannot Be Edited


Created By: Nune Margaryan On 01/31/2022 at 12:23 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: BCR "A PLACE TO GROW"
FACILITY NUMBER: 197601136

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82087(a)(3)

(a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. (3) Disinfectants, cleaning solutions, poisons, and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.
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 as cleaning solution was observed unlocked in kitchen cabinet which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/31/2022
Plan of Correction
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Kitchen cabinet was locked immediatly and no further action nedeed.
Type A
Section Cited
CCR
82088(e)(1)
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Hot water at the time of the visit was 98.7 degrees which is beyond the required 105 - 120 degrees
POC Due Date: 01/31/2022
Plan of Correction
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Hot water temperature was adjusted at the time of visit. No further action nedeed.
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:Wei Siew Ho
LICENSING EVALUATOR NAME:Nune Margaryan
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2022


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