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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600086
Report Date: 06/13/2024
Date Signed: 06/18/2024 12:21:09 PM

Document Has Been Signed on 06/18/2024 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
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:MARINE ATCFACILITY NUMBER:
198600086
ADMINISTRATOR/
DIRECTOR:		ERNESTINE BARNESFACILITY TYPE:
775
ADDRESS:426 E. 99TH STREETTELEPHONE:
(310) 330-8368
CITY:INGLEWOODSTATE: CAZIP CODE:
90301
CAPACITY: 125CENSUS: 56DATE:
06/13/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Fusi Austin and Charlene Mathews TIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1- year visit with the primary focus on Infection Control measures and using the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the assessment, the facility is clear of COVID-19 infection. LPA Bunker met with Operation Director Fusi Austin and Human Resource Director/Secretary Charlene Mathews and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved mitigation plan report and infection control plan. The facility is licensed to serve (80) ambulatory and (45) non-ambulatory clients aged 18 through 59. Currently, there are 56 clients present during today's visit. The facility has a 1 to 3 ratio. The Day Program is vendored by Westside Regional Center.

LPA Bunker and staff toured the entire Adult Day Program which included the following: Front lobby, receptionist/front office, administrative offices, conference rooms, 15 classrooms, gym, 3 dressing/changing rooms, main kitchen, dining room, transportation coordinator’s office, classrooms 1-15, 2 transitional classrooms, 2 small kitchens, 17 restrooms, supervisor station, laundry room, staff lounge, storage rooms, basement, courtyard, outdoor shaded area. All areas are in compliance. Each room is adequately equipped and furnished.
See continued LIC812 on page #2
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: MARINE ATC
FACILITY NUMBER: 198600086
VISIT DATE: 06/13/2024
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Continued LIC809 page #2

The day program has posted current activity schedules, and each instructor develops and follows specific monthly lesson plans.

The Adult Day Program is located in a commercial business building located in a residential neighborhood, operating hours are 8:00 A.M. - 4:30 P.M., and clients are at the day program from 8:00 A.M. - 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 food for clients, or if the clients are out in the community, the facility staff will pack a sack lunch for their consumers. Clients are trained in preparing simple meals.

During the visit, LPA observed the facility's infection control practices. LPA reviewed the screening protocol for visitors, staff, and clients. There are sanitizing stations in common areas and restrooms. LPA observed the facility has a 90-day supply of Personal Protective Equipment (PPE).

Documents are posted as mandated. The following Title 22 regulated areas were audited and found to be in compliance: Hot water temperature measured at 120 degrees Fahrenheit, smoke and carbon monoxide detectors were in compliance, fire extinguishers are fully charged, rest-rooms are clean and operational, toxic/sharp items locked inaccessible to clients. Hazardous items are inaccessible to clients and the first aid kit is fully stocked. A fire/emergency drill was conducted on Tuesday, June 11, 2024. The day program grounds are free of debris/hazards. See continued LIC809-C page 3
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: MARINE ATC
FACILITY NUMBER: 198600086
VISIT DATE: 06/13/2024
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Continued LIC809-C page 3

Due to time constraints, LPA Bunker will return at a later date to complete the visit.

There were no deficiencies cited.

Exit interview conducted.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
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