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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600550
Report Date: 09/21/2022
Date Signed: 09/21/2022 11:13:04 AM

Document Has Been Signed on 09/21/2022 11:13 AM - 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 CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:NEW DAY BEHAVIORFACILITY NUMBER:
198600550
ADMINISTRATOR:SANTOS DOMINGUEZFACILITY TYPE:
775
ADDRESS:1755 S. BARRANCA AVE.TELEPHONE:
(626) 966-1136
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY: 30CENSUS: 69DATE:
09/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:02 AM
MET WITH:Santos Dominguez- Program DirectorTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) V. Maldonado conducted an unannounced visit at the facility to conduct the required annual inspection, using the Infection Control Evaluation Tool. LPA Maldonado met with Program Director Santos Dominguez and explained the purpose for the visit. The facility is an Adult Day Program for Intellectually Disabled Adults, licensed to serve 20 ambulatory and 10 non-ambulatory clients, ages 18 and over.

During today's visit the LPA observed a COVID-19 screening at the entrance of the facility. Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing. The facility has personal protective equipment (PPE) for over 30 days. All cleaning supplies/toxins were observed to be stored inaccessible to consumers. Activity rooms were free of hazards. The hot water temperature was tested in the consumer bathrooms/shower room and tested at 92.4*F, 90.6*F*, and 89.5*, which does not meet the Title 22 Regulations requirement. The bathrooms were clean and have the required grab bars for non-ambulatory consumers. A fire alarm system was observed in the building. The program maintains a comfortable temperature throughout the building. There is a refrigerator and microwave in working conditions for the consumers. The equipment and furniture are in good repair. The program does not assist consumers with medications. LPA reviewed 4 staff files for criminal record clearances and associations to the program. Staff have complete health screenings, current first aid/CPR certificates, and proof of the required annual training. LPA also reviewed 6 consumer files and observed admission agreements, updated needs and services plans, pysician's reports and updated emergency contact information.

Per California Code of Regulations, Title 22, deficiencies were observed and cited on the LIC809-D.

An exit interview was conducted with Program Director Santos Dominguez and a copy of the report was provided.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Valeria Maldonado
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2022
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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Document Has Been Signed on 09/21/2022 11:13 AM - It Cannot Be Edited


Created By: Valeria Maldonado On 09/21/2022 at 11:01 AM
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: NEW DAY BEHAVIOR
FACILITY NUMBER: 198600550

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82088(e)(1)
82088 Fixtures, Furniture, Equipment, and Supplies
(e)Faucets used by clients for personal care shall deliver hot water.(1)Hot water temperature controls shall be maintained… to attain a hot water temperature of not less than 105 degrees F… and not more than 120 degrees F...

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in 3 of 3 bathroom sinks where the water tested between 89.5*F - 92.4*F, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/30/2022
Plan of Correction
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Program Director has scheduled maintenance on the water system for 09/23/22. A water temperature log will be completed for 5 days following the maintenance, and will be emailed to LPA as proof of correction by the POC due date.
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:Fernando Fierros
LICENSING EVALUATOR NAME:Valeria Maldonado
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2022


LIC809 (FAS) - (06/04)
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