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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600193
Report Date: 02/28/2024
Date Signed: 02/28/2024 01:11:10 PM

Document Has Been Signed on 02/28/2024 01:11 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
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: 37DATE:
02/28/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:54 AM
MET WITH:Ivana Reyes-Program DirectorTIME COMPLETED:
12:50 PM
NARRATIVE
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On 2/28/2024, Licensing Program Analysts (LPAs) Darneisha Cross and Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPAs met with Ivana Reyes-Director. The facility profile shows that the facility is licensed for a capacity of (40) clients, of which (35) can be ambulatory and (5) non-Ambulatory. The program director stated that the facility has (37) clients enrolled in the program. The total number of non-ambulatory clients attending the program is (2). The staff-to-client ratio is: (1) to (1), (1) to (2), (1) to (3) and (2) to (1). Director stated that the facility has (0) clients with a Restricted Health Care condition. Currently, there are (0) clients using protective or assisted devices. The facility conducted a fire drill on 2/14/24, and a Disaster Plan was on file. The program provides transportation.

LPA Iniguez and Cross and Director toured the entire facility inside and out. Documents are posted as mandated by the DPH and CCLD. The (2) bathrooms are clean and operational. No firearms are stored at facility and no bodies of water present. Medications are not kept in the facility. Facility does not provide food for clients; clients bring their own lunch.

As a part of today's inspection, LPA reviewed (3) client records, (3) staff records, and inspected the entire facility inside and out. LPA and Director toured the entire facility. All records were maintained properly.


Evaluation Report continues LIC 809-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2024
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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: WORK N PROGRESS
FACILITY NUMBER: 198600193
VISIT DATE: 02/28/2024
NARRATIVE
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Evaluation Report continues LIC 809-C

Inside areas are free of hazards and obstructions. (2) restrooms have working toilets and wash basins. They will accommodate non-ambulatory clients in a wheelchair. Emergency Phone Numbers are Posted & readily available for review in the activity area. Fire Extinguishers are up to fire code. The facilities telephone system is working correctly.
Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature properly measure between 105F° and 120F°: bathroom #1 was 109.2°F, bathroom, #2 was 106.3°F and kitchen sink was 109.5°F . A comfortable temperature is maintained in the facility. Smoke detectors and carbon monoxide alarm system is build-in and checked by the fire department every year. The facility is equipped with central air. All poisons were kept locked at the time of visit.

A first aid kit has been inspected, with at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and current first aid manual, which are stored in locked steel drawers, available for staff use but inaccessible to clients.
The facility does not handle the cash resources of clients or manage clients’ medications. Facility is current with their annual fees.

Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below:

-S#1 does not have a fingerprint clearance. (Civil Penalty Assessed)

-S#2 and S#3 not associated at facility.

-C#1 and C#3 missing medical assessment and TB test.

An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Ivana Reyes/Program Director.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 02/28/2024 01:11 PM - It Cannot Be Edited


Created By: Alfonso Iniguez On 02/28/2024 at 12:31 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
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WORK N PROGRESS
FACILITY NUMBER: 198600193

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1522(c)(1)
General Provisions
(c)(1) Subsequent to initial licensure, a person specified in subdivision (b) who is not exempted from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification pursuant to subdivision (g) of this section or Section 1522.7 from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in having S#1 not cleared to work at the program which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/29/2024
Plan of Correction
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Licensee will ensure all staff is cleared at all times. As part of plan of correction, licensee will ensure R#1 has a clearance on file. Licensee will send proof of correction to LPA before POC due date.
Type A
Section Cited
CCR
82019(e)(3)
Criminal Record Clearance
(e) Prior to working, residing or volunteering in a licensed day program, all individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall do the following: (3) Request the licensee or applicant for a license to request a transfer of a criminal record clearance as specified in Section 82019(f); or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in having S#2 and S#3 associated at the program which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/29/2024
Plan of Correction
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Licensee willl ensure all staff is associated at the program at all times. As part of Plan of Correction, licensee will associate S#2 and S#3 to day program before POC due date.
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:Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2024


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 02/28/2024 01:11 PM - It Cannot Be Edited


Created By: Alfonso Iniguez On 02/28/2024 at 12:31 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
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WORK N PROGRESS
FACILITY NUMBER: 198600193

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82069(a)(1)
Client Medical Assessments
(a) Prior to or within 30 calendar days following the acceptance of a client, the licensee shall obtain a written medical assessment of the client that determines the licensee's ability to provide necessary health-related services to the client. The assessment shall be used in developing the Needs and Services Plan. (1) The assessment shall be performed by a licensed physician or designee, who is also a licensed professional, and the assessment shall not be more than one year old when obtained.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) and (record review)], the licensee did not comply with the section cited above in having C#1 and C#3 not having a medical assesment which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/18/2024
Plan of Correction
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Licensee will ensure all clients have a medical assesment on file. As part of Plan of Correction, licensee will provide C#1 and C#3 medical assesment to LPA via email before the POC due date.
Type B
Section Cited
CCR
82069(b)(1)
Client Medical Assessments
(b) The medical assessment shall include the following: (1) The results of an examination for communicable tuberculosis and other contagious/infectious diseases.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (record review)], the licensee did not comply with the section cited above in C#1 and C#3 not having a TB test on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/18/2024
Plan of Correction
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Licensee will ensure all clients have a TB test on file. As part of Plan of Correction, licensee will provide C#1 and C#3 proof of TB test to LPA via email before the POC due date.
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:Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2024


LIC809 (FAS) - (06/04)
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