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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600193
Report Date: 02/09/2022
Date Signed: 02/09/2022 07:39:36 PM

Document Has Been Signed on 02/09/2022 07:39 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:WORK N PROGRESSFACILITY NUMBER:
198600193
ADMINISTRATOR:CLINESE DAVISFACILITY TYPE:
775
ADDRESS:138 NEVADA STREETTELEPHONE:
(310) 647-7988
CITY:EL SEGUNDOSTATE: CAZIP CODE:
90245
CAPACITY: 40CENSUS: 3DATE:
02/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:37 AM
MET WITH:Ivana Reyes - client servicesTIME COMPLETED:
01:45 PM
NARRATIVE
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On 02/09/2022, Licensing Program Analyst (LPA) Don Senaha conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with client services Ivana Reyes and explained the purpose of today’s visit. The day program is licensed to operate for forty (40) developmentally disabled clients ages 18 and over of which five (5) can be non-ambulatory/ The consumers are Westside Regional Center clients.

The day program is a single-story structure located in a commercial neighborhood. It consists of the following: front lounge, front office open area, kitchen area with refrigerator, bullpen area used for arts and crafts and various activities, three (3) managers offices, television room area, 2 bathrooms (one men and one women restroom) located in back area, break room with a refrigerator, four (4) more administrative offices on the north side of the facility with a closet and a shared bathroom.



LPA and client services toured the physical plant. There were no bodies of water or obstructions on the premises. Rooms were inspected and had adequate lighting furnishings. Bathrooms were found to be within Title 22 regulations and were clean and operational.

LPA observed the day program to be sanitary and appropriately supplied at the time of visit. Medications are to be stored in a locked in a cabinet near the back area. Cleaning supplies and toxins were in the locked storage room and not accessible to clients. Four (4) fire extinguishers were charged and facility has a pull down fire alarm system.

Evaluation Report Continues on LIC 809-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Don Senaha
LICENSING EVALUATOR SIGNATURE: DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: WORK N PROGRESS
FACILITY NUMBER: 198600193
VISIT DATE: 02/09/2022
NARRATIVE
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During this visit, LPA observed the day program's infection control practices. LPA observed screening protocols for visitors, staff, and consumers, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility had a sufficient supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted.

The facility was cited for three (3) deficiencies during this inspection visit. See D page.

An exit interview was conducted and a copy of this report was provided to client services Ivana Reyes.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Don Senaha
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022
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Document Has Been Signed on 02/09/2022 07:39 PM - It Cannot Be Edited


Created By: Don Senaha On 02/09/2022 at 01:05 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: WORK N PROGRESS
FACILITY NUMBER: 198600193

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82087(a)(3)
Buildings and Grounds
(a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. (3) Disinfectants, cleaning solutions, poisons, and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on oservation, the licensee did not comply with the section cited above as LPA visually saw scissors unlocked and accessible to clients which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/09/2022
Plan of Correction
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Client Services Ivana Reyes immediately removed and locked up the scissors in the office.
Type A
Section Cited
CCR
82088(e)(1)
Fixtures, Furniture, Equipment, and Supplies
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation), the licensee did not comply with the section cited above as LPA measured the water temperature in the bathrooms under 105 degrees Farenheit which did not meet Title 22 regulations which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2022
Plan of Correction
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Client Services will have plumber come out and service water by 2/14/22.
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:Eva M Alvarez
LICENSING EVALUATOR NAME:Don Senaha
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2022


LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 02/09/2022 07:39 PM - It Cannot Be Edited


Created By: Don Senaha On 02/09/2022 at 01:05 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: WORK N PROGRESS
FACILITY NUMBER: 198600193

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82087(a)
Buildings and Grounds
(a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, LPA observed the sink faucet in the kitchen only having a trickle of hot water coming out of the faucet which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/16/2022
Plan of Correction
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Client Services will have plumber come out and fix faucet by 02/16/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Eva M Alvarez
LICENSING EVALUATOR NAME:Don Senaha
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2022


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