197606588-3-21-2022-28-AS-CWOG-CCQTZ2-20220321150938

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197606588
Report Date: 03/21/2022
Date Signed: 03/21/2022 10:34:29 PM

Document Has Been Signed on 03/21/2022 10:34 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:	TURNING POINT QUALITY CARE		FACILITY NUMBER:	197606588
ADMINISTRATOR:	WILMA CARSTENSEN		FACILITY TYPE:	740
ADDRESS:	15903 CLEAR SPRING DRIVE		TELEPHONE:	(562) 943-7900
CITY:	LA MIRADA	STATE: CA	ZIP CODE:	90638
CAPACITY:	6	CENSUS: 5	DATE:	03/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:18 PM
MET WITH:	Wilma Carstensen		TIME COMPLETED:	03:30 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	Licensing Program Analyst (LPA) Christine Wong conducted an unannounced annual required visit. LPA met with caregiver Emelyn Bonifacio and explained the reason for the visit. Shortly after, the administrator Wilma Carstensen arrived and assisted with the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant, COVID-19 procedures, reviewed residents' medications, observed food supply, and reviewed resident and staff files. Facility has submitted a mitigation plan and pending for approval. The facility is a single story house and located in a residential neighborhood. The facility consists of four (4) residents bedrooms, two bathrooms, one live in staff room, kitchen, laundry area, staff office, dining room and a detached garage. The first and fourth residents bedrooms have two beds, two chairs, two drawers, and required linen and furniture and sufficient lighting and closet space. The second and third residents bedrooms have one bed, one chair, one drawer, required linen and furniture and sufficient lighting and closet space. The two residents bathrooms are clean and operational. The hot water temperature in the two bathrooms were measured at 116.9 and 118.8 degrees F. which are within the range of Title 22 regulations. The food supply in the kitchen and pantry has at least two days perishable and seven days non perishable food. The front and back yard are maintained well. The back yard has shaded area with tables and chairs for residents to use. The exit and passage way are free of obstruction. All the appliances are clean and working properly except the conventional oven but they do have a toaster oven for replacement. The common areas such as living room and dining room are clean and have the required furniture. The smoke detectors and carbon monoxide detectors are located in each residents bedrooms and common area and they are working properly. LPA reviewed 5 resident files to confirm emergency contact is updated. LPA also reviewed staff files to confirm health screenings and fingerprint clearances. Staff #2 (S2) did not have a health screening on file. LPA reviewed all 5 residents medication and all medications are accurate and updated.

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Christine Wong	TELEPHONE: (323) 981-3963
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

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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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: TURNING POINT QUALITY CARE	FACILITY NUMBER: 197606588
	VISIT DATE: 03/21/2022

NARRATIVE

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Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, disinfecting products are available in each resident room and bathroom and facility is disinfected every shift or as needed or every time resident finished eating, bathrooms have sufficient soap, paper towels, and washing hands signs, and PPE supplies are stored for more than 30 days.

The following deficiency is cited under the California Code of Regulations Title 22 Division 6 Chapter 8

An exit interview is conducted, copy of the report and appeal rights given was provided to the administrator.

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Christine Wong	TELEPHONE: (323) 981-3963
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/21/2022 10:34 PM - It Cannot Be Edited

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: TURNING POINT QUALITY CARE	FACILITY NUMBER: 197606588
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/21/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

87411(f)

87411 Personnel Requirement-General (f)All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, LPA obseved Staff#2 (S2) does not have a health screening on file and she's been worked the facility for a year already.
	POC Due Date: 04/04/2022
	Plan of Correction
1 2 3 4	Administrator ensure each staff will be in good health and physically and mentally capable of perform assigned tasks and shall be verified by a health screening. Administrator will send the copy of health screening for S2 to LPA by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Christine Wong	TELEPHONE: (323) 981-3963
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

LIC809 (FAS) - (06/04)

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