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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600193
Report Date: 01/24/2025
Date Signed: 01/24/2025 12:23:50 PM

Document Has Been Signed on 01/24/2025 12:23 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:WORK N PROGRESSFACILITY NUMBER:
198600193
ADMINISTRATOR/
DIRECTOR:		CLINESE DAVISFACILITY TYPE:
775
ADDRESS:138 NEVADA STREETTELEPHONE:
(310) 647-7988
CITY:EL SEGUNDOSTATE: CAZIP CODE:
90245
CAPACITY: 40CENSUS: 38DATE:
01/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:16 AM
MET WITH:Director of Client Services Ivana ReyesTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
NARRATIVE
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On 01/24/2025, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with the Director of Client Services Ivana Reyes. LPA explained the purpose of the visit. The total number of non-ambulatory clients attending the program is one. The facility conducted a fire drill on 01/22/2025. The program does not provides transportation.

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 Director toured the entire facility inside and out. The (2) bathrooms are clean and operational. Water temperature measured at 107.4 degrees F. No firearms are stored at facility and no bodies of water present. Facility does not provide food for clients; clients bring their own lunch and water.

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. Continue to LIC809-C.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2025
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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: WORK N PROGRESS
FACILITY NUMBER: 198600193
VISIT DATE: 01/24/2025
NARRATIVE
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All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Cleaning supplies and toxins were in the locked storage room and not accessible to clients. Four (4) fire extinguishers last serviced in March 2024 and the facility has a pull-down fire alarm system. Carbon monoxide detector was tested. Documents are posted as mandated. First aid kit is fully stocked.

Five (5) staff records were reviewed, 5 out of 5 staff records had required criminal record clearances or criminal record exemptions.

Five (5) client records were reviewed. Two client medications were reviewed.

Deficiencies are being cited based on record review in accordance with the California Code of Regulations, Title 22, see LIC809D.

During record review, LPA did not observe a medical assessment for Client #3.

An exit interview was conducted, technical assistance provided, and Plans of Corrections were developed and reviewed. A copy of this report and appeal rights were discussed and left with the Director of Client Services Ivana Reyes.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/24/2025 12:23 PM - It Cannot Be Edited


Created By: Regina Cloyd On 01/24/2025 at 12:15 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: 01/24/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82070(b)(8)
Client Records. (b) Each record must contain information including, but not limited to, the following: (8) Medical assessment, including ambulatory status, as specified in Section 82069(b).


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above for one out of five clients which poses/posed a potential health risk to persons in care. LPA did not observe a medical assessment for Client #3 (C3).
POC Due Date: 02/04/2025
Plan of Correction
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The Licensee will email C3's medical assessment to regina.cloyd@dss.ca.gov by the POC due date. The Licensee will ensure all current clients have a medical assessment on file.
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:Ulysses Coronel
LICENSING EVALUATOR NAME:Regina Cloyd
LICENSING EVALUATOR SIGNATURE:
DATE: 01/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/24/2025


LIC809 (FAS) - (06/04)
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