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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198320220
Report Date: 11/16/2022
Date Signed: 11/16/2022 12:21:51 PM

Document Has Been Signed on 11/16/2022 12:21 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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:BRIDGES TO RECOVERY-MAPLE DRIVEFACILITY NUMBER:
198320220
ADMINISTRATOR:SMITH, MELISSA LCSWFACILITY TYPE:
772
ADDRESS:721 MAPLE DRIVETELEPHONE:
(310) 275-4620
CITY:BEVERLY HILLSSTATE: CAZIP CODE:
90210
CAPACITY: 6CENSUS: 3DATE:
11/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Margaret Giuffre, Program Director / OperationsTIME COMPLETED:
12:30 PM
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On 11/16/2022, Licensing Program Analyst (LPA) Troy Agard conducted an unannounced required annual visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA Agard met with Margaret Giuffre, Program Director / Operations. A risk assessment was conducted. Based on the assessment, the facility is clear of Covid-19 infection. LPA verified that the facility has an approved mitigation plan report.

The facility is licensed for six (6) ambulatory clients. There is currently one client in placement. LPA was granted access and allowed to enter the facility to conduct the inspection. LPA was properly screened for Covid-19 symptoms and temperature was checked.

During the tour, LPA observed the facility’s infection control practices. PPE supplies are readily available to staff, and additional supplies are stored. Sufficient paper, cleaning, and disinfecting supplies were observed. The facility’s designated visitation areas are located throughout the facility. Staff were observed wearing a face covering. LPA observed some covid posting throughout the facility.

All five (5) rooms were inspected. Rooms were observed clean and in good repair. Mattress and bed frames were observed to be in good condition. Adequate lighting was observed in all rooms and bathrooms. Storage for client’s personal belongings was observed and plentiful. The required furnishings were observed in all rooms.

There are no security bars or weapons on the premises. Client bathrooms were checked. LPA observed sufficient liquid soap and hand towels. LPA observed lighting, faucet and fixtures to be working in all bathrooms. Showers were free of mold/mildew. The water temperature measured at 110 F. A comfortable temperature was maintained in the facility.

LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of

cont on 9099C

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: BRIDGES TO RECOVERY-MAPLE DRIVE
FACILITY NUMBER: 198320220
VISIT DATE: 11/16/2022
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non-perishable food. Knives and toxins were observed locked and inaccessible to clients in care. Centrally stored medications were observed stored inaccessible to clients in care. Several fire extinguishers were observed throughout the facility.

Outside grounds were toured. LPA Agard observed a pool that was gated with a 5-foot fence and has a lock. Administrative office is located in the backyard beyond the pool. Pool fencing meets the regulations for buildings and grounds. No pets observed. Walkways around the facility were clear of hazards. Common areas were clean and clear of hazards; doorways were free of obstructions.

No deficiencies were cited during today’s visit.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
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