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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197802699
Report Date: 11/15/2021
Date Signed: 11/15/2021 03:51:07 PM

Document Has Been Signed on 11/15/2021 03:51 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:IRL-THE ALMANSOR CENTERFACILITY NUMBER:
197802699
ADMINISTRATOR:NITA DAVISFACILITY TYPE:
775
ADDRESS:211 PASADENA AVENUETELEPHONE:
(323) 341-5580
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY: 60CENSUS: 66DATE:
11/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Marcela Alvarez - Administrator Assistant
Nita Davis - Director
TIME COMPLETED:
04:00 PM
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Licensing Program Analyst(s)(LPA) Mary Flores and Jewel Baptiste conducted an unannounced annual inspection visit at the facility with focus on infection control domain. LPAs met with Marcela Alvarez Administrator Assistant and explained the reason of the visit.

Adult Day Program operates Monday through Friday from 8:00 AM to 2:00 PM and provides services for the developmentally disabled clients from various Regional Center. This program is a large building consisted of two floors. Facility has two kitchens, one is located upstairs and the other one is located downstairs. Facility has a fire sprinkle system and smoke detectors.

LPAs toured the facility with Administrator Assistant Marcela Alvarez and observed the following:
1st floor has a reception office, 4 staff offices, a staff break area, a vocational area, a kitchen, and a large space separated into two homerooms/classrooms #1, and #2. The basement has one medium space use as homeroom #3, a large space use as homeroom #4,#5,#6, an office space as room #7, and a computer lab area with 6 stations, and 2 client private bathrooms. Water temperature was tested in client bathroom; bathroom #1 and #2 water tested at 108.9 degrees F which is within the required water temperature. Knives for food preparation/class are kept in a lock drawer in the reception office. Medication or meals are not handle in the facility. Clients bring their meals from home. Files were reviewed for staff #1, and #2 and client #1, and #2. Fire extinguisher was observed in the kitchen area, last checked on 3/21.
Facility is following COVID 19 recommendations, signs are posted throughout the facility, one entry point with electronic screening station for clients, staff, and visitors. High touch areas, and computers are disinfected between uses. Facility is currently keeping a 1:3 ratio within each classroom. N95 Fit Test will be conducted in within a month and a closed lid trash cans will be kept in isolation area.

No deficiencies were observed during this visit, technical advisories were provided. Exit interview was conducted with Georgina Hernandez Program Supervisor and a copy of the report was provided.
SUPERVISORS NAME: Rebecca Orendain
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2021
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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