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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600550
Report Date: 09/15/2023
Date Signed: 09/15/2023 02:01:43 PM

Document Has Been Signed on 09/15/2023 02:01 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
GREATER LA AC/SC, 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: 17DATE:
09/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Santos DomiguezTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced visit at the facility to conduct the required annual inspection. LPA Ramirez 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 consumers, ages 18 and over.

LPA Ramirez observed a refrigerator and kitchen sink. Refrigerator was observed to be in working order. Facility has a refrigerator to store clients packed lunches from home. LPA Ramirez observed some extra juices in a lower refrigerator drawer. Per S5, the facility has the drinks on hand in case a client forgets their drink or snack. LPA Ramirez observed a fully charged fire extinguisher in this area. LPA Ramirez observed facility sketch plans in this area. LPA Ramirez 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. 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. The program does not assist consumers with medications. LPA Ramirez reviewed six (6) 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 Ramirez reviewed six (6) consumer files and observed admission agreements, updated needs and services plans, pysician's reports and updated emergency contact information. LPA Ramirez reviewed and obtained a copy Infection Control Plan.

No deficiencies were cited during today's visit. An exit interview was conducted with Program Director Santos Dominguez and a copy of the report was provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2023
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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