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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600086
Report Date: 09/08/2022
Date Signed: 09/08/2022 02:52:47 PM

Document Has Been Signed on 09/08/2022 02:52 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:MARINE ATCFACILITY NUMBER:
198600086
ADMINISTRATOR:ERNESTINE BARNESFACILITY TYPE:
775
ADDRESS:426 E. 99TH STREETTELEPHONE:
(310) 330-8368
CITY:INGLEWOODSTATE: CAZIP CODE:
90301
CAPACITY: 125CENSUS: 33DATE:
09/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Fusi AustinTIME COMPLETED:
03:00 PM
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On 09/08/22, LPA Perry Scott made an unannounced Required- 1 Year visit to Marine ATC Adult Day Program. LPA Scott met with Operations Director, Fusi Austin and informed her that the purpose of today's visit was to conduct an annual inspection of the day program, with an emphasis on infection control. Additionally, LPA will tour the physical plant, review staff and client’s records. The Day Program is vendored by Westside Regional Center (WRC). There are currently 92 consumers attending the Day Program. There were 33 consumers in attendance at the time of this inspection. Marine ATC annual fees are past due with a current balance of $2,270.00.

LPA Scott, Austin, and staff toured the entire facility which included the following:
Lobby, reception/front office, administrative offices, conference room, classrooms, gym, changing rooms, main kitchen, dining room, recycling classroom, computer room, small kitchen, 17 restrooms, laundry room, staff lounge, storage rooms, basement, outdoor shaded area. All areas are complying with current title 22 guidelines. There were no hazards or obstructions in the interior or exterior. Each room is adequately equipped and furnished. The day program has posted current activity schedules, and each instructor develops and follows specific monthly lesson plans. All fire extinguishers were fully charged and last serviced on 03/01/22. The last fire drill was conducted on 06/08/22.

Continued LIC812 on page #2

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2022
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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: MARINE ATC
FACILITY NUMBER: 198600086
VISIT DATE: 09/08/2022
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Further, the LPA reviewed two (2) consumer files as well as two (2) staff files which were current and updated with required records. As part of the inspection, my primary focus was on infection control. LPA observed the facility’s infection control practices: LPA observed a sanitizing station at the facility entrance. PPE supplies are readily available to consumers and staff, and additional supplies are stored. Sufficient paper, cleaning, and disinfecting supplies were observed. Logs are kept indicating the times when cleaning and sanitizing is completed. And LPA was screened for COVID-19 at the door, temperature was taken, and logged in the visitors log in book.

The Adult Day Program is in a commercial business building located in a residential neighborhood, operating hours are 8:00 A.M. to 4:30 P.M., clients are at the day program from 8:00 A.M. to 2:00 P.M.; 5 days a week Monday through Friday. All consumers bring their own lunch, if clients forget their lunch the day program will provide a snack. Clients are trained in preparing simple meals. They participate in stimulating activities inside the facility as well as through zoom sessions.



There were no deficiencies cited.

Exit interview conducted and a copy of the Facility Evaluation Report will be given to Operations Director, Fusi Austin.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022
LIC809 (FAS) - (06/04)
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